S1386 The National Trends and Hospitalizations of Patients with Hereditary Hemochromatosis in the United States: Insights From the National Inpatient Sample

Abstract

Introduction: Hereditary hemochromatosis (HH) is a disorder of increased intestinal iron absorption leading to total body iron overload. Although it is among the most common genetic diseases globally, no large-scale nationwide data is available regarding HH-related hospitalizations in the United States. Our study aimed to find on a national level the demographics of the patients with HH, inpatient mortality, and resource utilization using the national inpatient database (NIS). Methods: We queried the nationwide inpatient (NIS) 2016-2019 databases using the ICD-10 CM codes to identify all the patients hospitalized with hereditary hemochromatosis (HH). We excluded patients under 18 years. The primary outcome of our study was to do an exploratory analysis and determine the baseline demographic characteristics of patients admitted with HH. The secondary outcomes included in-hospital mortality, length of stay (LOS), hospitalization cost, and outcomes. Results: A total of 196 adult patients with HH were admitted in the United States with a mean age of 59.3 years. The majority of the patients were males (55%) and Caucasians (97.2%). The mean length of stay was 6 days, and a total of 10 patients (0.5%) died in the hospital. Medicare (47.2%) was the most common insurance, and most of the patients were admitted to large tertiary care hospitals. Patients with concomitant Alcoholic Liver Disease (ALD) had greater LOS (7.5 days vs. 6 days) than patients without ALD. The rest of the demographics are shared in the Table. Conclusion: Our study demonstrated that most of the patients admitted with HH are Caucasians and males. The mean LOS is 6 days. The total mean cost of hospitalizations is $21,763.The HH patients with concomitant Hepatitis C and Alcoholic Liver Disease have higher healthcare utilization and worse outcomes than other patients. So, patients with HH should be screened for Hepatitis C and alcoholic Liver disease to improve the outcomes for these patients. Table 1. - Baseline patient and hospital characteristics and outcomes for HH-related hospitalizations Patient Characteristics Hereditary Hemochromatosis (HH) No. of patients 196 Male (%) 109 (55.7%) Mean age, (SD) years 59.38 Race [N, %] Caucasian 190 (97.04%) African American 0 Hispanic 0 Asian 6 (2.96%) Charlson Comorbidity Index Score [N, %] 0 56 (28.71%) 1 47 (24.07%) 2 19 (9.56%) 3 or more 74 (37.63%) Median Income (Zip Codes) [N, %] $1-$38,999 25 (12.97%) $39,000-$47,999 48 (24.29%) $48,000-$62,999 38 (19.17%) >$ 63,000 85 (43.54%) Insurance Provider [N, %] Medicare 93 (47.28%) Medicaid 14 (7.03%) Private 84 (42.94%) Others 2.7% Hospital Characteristics Hospital teaching Status [N, %] Non-Teaching 94 (48.05%) Teaching 102 (51.94%) Hospital Bed Size [N, %] Small 35 (17.79%) Medium 63 (32.07%) Large 98.2 (50.12%) Hospital Location [N, %] Rural 4 (1.8%) Urban 192 (98.11%) Outcomes HH HH & Hep C HH & ALD Mortality, no. % 10 (0.5%) 10(50%) 0 Length of Stay (SD) 6 5.9 7.5 Hospitalization cost (SD) $21,763 $38,161 $43,962