Abstract
Background: Hepatitis C virus (HCV) infection predisposes patients to other infectious diseases, such as sepsis. We aimed to analyze epidemiological trends of sepsis-related admissions, deaths, and costs in hospital admissions with chronic hepatitis C who had a hospital admission in Spain. Methods: We performed a retrospective study of all hospitalizations involving chronic hepatitis C in the Spanish Minimum Basic Data Set (MBDS) between 2000 and 2015. This period was divided into four calendar periods (2000–2004, 2005–2007, 2008–2011, and 2012–2015). Results: We selected 868,523 hospital admissions of patients with chronic hepatitis C over 16 years in the Spanish MBDS. Among them, we found 70,976 (8.17%) hospital admissions of patients who developed sepsis, of which 13,915 (19.61%) died during admission. We found an upward trend, from 2000–2003 to 2012–2015, in the rate of sepsis-related admission (from 6.18% to 10.64%; p < 0.001), the risk of sepsis-related admission (from 1.31 to 1.55; p < 0.001), and the sepsis-related cost per hospital admission (from 7198€ to above 9497€; p < 0.001). However, we found a downward trend during the same study period in the sepsis case-fatality rate (from 21.99% to 18.16%; p < 0.001), the risk of sepsis-related death (from 0.81 to 0.56; p < 0.001), and the length of hospital stay (LOHS) (from 16.9 to 13.9; p < 0.001). Moreover, the rate of bacterial Gram-positive and candidiasis infections decreased, while Gram-negative microorganisms increased from 2000–2003 to 2012–2015. Conclusions: Sepsis, in chronic hepatitis C patients admitted to the hospital, has increased the period 2000–2015 and has been an increasing burden for the Spanish public health system. However, there has also been a significant reduction in lethality and LOHS during the study period. In addition, the most prevalent specific microorganisms have also changed in this period.
Highlights
The World Health Organization (WHO) has estimated that there are around 71 million individuals with chronic hepatitis C worldwide, many of whom are unaware of their hepatitis C virus (HCV)
The rate of sepsis-related admissions was calculated as the number of hospital admissions with sepsis and chronic hepatitis C divided by all hospital admissions coded in the Minimum Basic Data Set (MBDS) with a diagnosis of chronic hepatitis C
In this retrospective study of hospital admissions of patients with chronic hepatitis C and sepsis in Spain during a 16-year period, from 2000 to 2015, we found that the rate of sepsis-related admissions, risk of sepsis, and sepsis-related costs increased, while the case-fatality rate (CFR) of sepsis, risk of sepsis-related death, and length of hospital stay (LOHS) decreased
Summary
The World Health Organization (WHO) has estimated that there are around 71 million individuals with chronic hepatitis C worldwide, many of whom are unaware of their hepatitis C virus (HCV). L2s02w0,i9t,h16c0h7ronic hepatitis C worldwide, many of whom are unaware of their hepati2tiosf 1C7 virus (HCV) infection [1]. Spain had one of the highest HCV infection prevalences in Europe in 2013 [2], with values around 1.5% for HCV antibodies and 1.2% for plasma HCV-RNA. This sinitfueaction [h1a].sScphaainngheaddaofnteerotfhtehaephpigehareasnt HceCoVf tinhfeecdtiiroenctp-arecvtianlgenacnetsivinirEalusro(DpeAiAns2)0w13it[h2]a, wpritehvavlaelnucees oarfoaunntidbo1.d5i%esfaogr aHinCsVt HanCtViboodf i0e.s8%anadn1d.2a%ctfiovrepHlaCsVmainHfeCctVio-RnNoAf 0. Sepsis is a substantial economic burden worldwide because patients with sepsis require a high expenditure on hospital resources, and the costs of sepsis are quite high [26,29]
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