Burden of hospitalizations over time with invasive aspergillosis in the United States, 2004\u20132013

Marya D Zilberberg,Andrew F Shorr,Rachel Harrington,James R Spalding

doi:10.1186/s12889-019-6932-9

Abstract

BackgroundUsing aggregated data available on the interactive website from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project Network (HCUPnet), we examined the annual volume of invasive aspergillosis (IA)-related hospitalizations in the US.MethodsThis was a population study. Age-adjusted volumes were derived through population incidence calculated using year-specific censal and intercensal US population estimates available from the US Census Bureau. We additionally examined IA as the principal diagnosis and its associated outcomes in patients with ICD-9-CM codes 117.3, 117.9 and 484.6.ResultsThe age-adjusted number of annual hospitalizations with IA grew from 35,968 cases in 2004 to 51,870 in 2013, a 44.2% overall increase, 4.4% per annum. Regionally, the South contributed the plurality of the cases (40%), and the Northeast the fewest (17%). While IA as principal diagnosis dropped, from 14.4 to 9.3%, mortality rose from 10 to 12%. Despite mean hospital length of stay decreasing from 13.3 (standard error [SE] 0.07) to 11.5 (SE 0.6) days, the corresponding mean hospital charges rose from $71,164 (SE $5248) to $123,005 (SE $9738). The aggregate US inflation-adjusted hospital charges for IA principal diagnosis rose from $436,074,445 in 2004 to $592,358,369 in 2013.ConclusionsGiven the substantial volume and rate of growth in IA-related hospitalizations in the US between 2004 and 2013, an increase in mortality and high costs, IA may represent an attractive target for intensive preventive efforts.

Highlights

Using aggregated data available on the interactive website from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project Network (HCUPnet), we examined the annual volume of invasive aspergillosis (IA)-related hospitalizations in the US
The data for this analysis were derived from the HCUPnet, a website for querying aggregate data from the Healthcare Cost and Utilization Project (HCUP), administered by Zilberberg et al BMC Public Health (2019) 19:591 unadjusted mortality, length of stay (LOS), costs and charges in this cohort
Between years 2004 and 2013, the total volume of annual hospitalizations related to IA rose from 29,774 (SE 2425) to 51,870 (SE 2642), a 74.2% overall growth (Fig. 1)

Summary

Introduction

Using aggregated data available on the interactive website from the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project Network (HCUPnet), we examined the annual volume of invasive aspergillosis (IA)-related hospitalizations in the US. Invasive aspergillosis (IA) represents a severe infection in many types of patients. It is a growing problem, given the broader use of intensive immunosuppressive regimens for various diseases, increases in organ transplantation and improved diagnostics [1, 2]. Recent US studies described a substantial increase in the prevalence of IA in general, and among patients with hematologic malignancies and those undergoing organ transplants [3]. Despite aggressive prophylaxis in select populations, IA remains associated with high crude and attributable mortality, and by some estimates, Limited data exist, describing in detail recent trends in epidemiology and outcomes associated with IA. We aimed to explore time trends in the prevalence, mortality and hospital resource utilization associated with IA among a diverse cohort of hospitalized patients

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