Inpatient Burden of Complications of Cirrhosis in the United States: An Analysis of National Trends from 2005 to 2010: Presidential Poster

Abstract

Purpose: Cirrhosis is responsible for significant morbidity and health-care costs in the U.S. There is limited data, however, on the inpatient burden of complications of cirrhosis in the U.S. The aim of this study was to evaluate inpatient admission rate, length of stay, percent in-hospital mortality, and associated costs related to complications of cirrhosis from 2005 to 2010. Methods: We analyzed the National Inpatient Sample Database (NIS) for all subjects in which the principal discharge diagnosis was a specific complication of cirrhosis {ascites (ICD-9 code 789.5), hepatic encephalopathy (HE) (572.2), hepatorenal syndrome (HRS) (572.4), variceal hemorrhage (VH) (456.0, 456.2), or spontaneous bacterial peritonitis (SBP) (567.23)} from 2005-2010. The NIS contains data from approximately 8 million hospital stays each year. Chi-square test for trend was utilized to assess the statistical significance. A p<0.05 was considered significant. Results: A total of 377,270 hospital admissions were analyzed over the study period. In 2005, there were 56,032 inpatient discharges attributed to complications of cirrhosis, as compared to 72,035 in 2010 (p<0.05). The mean length of stay has stayed relatively stable between 2005 and 2010, at 5.6±0.1 days (p>0.05). The mean hospital charges have increased by 1.5-fold from $24,772 in 2005 to $38,041 in 2010 (p<0.05). The inpatient mortality rate, however, decreased from 8.1% in 2005 to 7.1% in 2010 (p<0.05). In 2010, 66.8% discharges were due to HE, 12.9% due to ascites, 9.6% due to SBP, 6.0% due to VH, and 4.3% due to HRS. Average total charges were $70,238 for HRS, $46,970 for SBP, $41,070 for VH, $36,978 for HE, and $24,706 for ascites. Specific percent in-hospital mortality was 31.3% for HRS, 7.6% for SBP, 6.7% for hepatic encephalopathy, 5.5% for VH, and 1.7% for ascites. Conclusion: The inpatient admission rates and the associated costs for complications of cirrhosis are on a rise. Further analysis is required to identify factors associated with these admissions that may be amenable to targeted interventions. The hospital mortality as a result of complications of cirrhosis is high, but has been declining in recent years.Figure: Total number of discharges related to complications of cirrhosis, 2005-2010.