Original article—liver, pancreas, and biliary tractNationwide Increase in Hospitalizations and Hepatitis C Among Inpatients With Cirrhosis and Sequelae of Portal Hypertension
Section snippets
Data Source
All data were extracted from the NIS between 1998 and 2003. It is the largest all-payer database of national hospital discharges, maintained as part of the Healthcare Cost and Utilization Project by the Agency for Healthcare Research and Quality. The NIS is a 20% stratified sample of nonfederal, acute-care hospitals in the United States. This sample includes community and general hospitals and academic medical centers, but excludes long-term facilities. Each record in the NIS represents a
Rates of Hospitalization
The overall rate of hospitalization for cirrhosis complicated by portal hypertension among all individuals in the US census was 23.6 per 100,000 persons annually between 1998 and 2003. Stratified by year, the annual incidence of hospitalization was 21.4 per 100,000 in 1998, 21.7 per 100,000 in 1999, 22.7 per 100,000 in 2000, 23.5 per 100,000 in 2001, 25.4 per 100,000 in 2002, and 26.6 per 100,000 in 2003. On average, there was a statistically significant 5% annual increase in hospitalization
Discussion
In this national study, we found an increase in the estimated incidence of hospitalizations for cirrhosis and complications of portal hypertension in a relatively short 6-year period. We also observed a concurrent increase in the proportion of patients with decompensated cirrhosis with HCV infection. There was a concomitant increase in the total economic burden arising from hospitalizations for complications of portal hypertension that was most pronounced among the subgroup with HCV infection
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Supported by a Ruth L. Kirschstein individual postdoctoral fellowship grant by the National Institutes of Health (F32DK076257, G.C.N.).