title: Increasing Volume but Decreasing Mortality of Hospitalized Hepatitis C Patients in the United States, 2005 to 2011.
abstract: BACKGROUND
  Patients with hepatitis C virus infection often require hospitalization for progressive liver disease and complications, incurring high cost and risk of death.
  
  
  OBJECTIVE
  The aim of our study was to investigate recent trends in the economic burden and outcomes of patients hospitalized for hepatitis C in the United States.
  
  
  METHODS
  Patients with hepatitis C-associated hospitalization were identified from the Nationwide Inpatient Sample 2005 to 2011. We analyzed the in-hospital mortality, hospital service utilization, demographic, and clinical features of patients. A prognostic model to predict in-hospital survival and death with independent risk factors for mortality was developed.
  
  
  RESULTS
  A total of 607,279 cases of hepatitis C-associated hospitalization were identified. Over 7 years, the annual hospitalized volume increased by 28.8%. In-hospital mortality declined from 8.2% to 6.4%. Median length of stay (4 d) was unchanged but the inflation-adjusted hospital charges increased by 33.3%. Acute respiratory failure was the greatest independent risk factor for mortality [odds ratio (OR)=7.3; 95% confidence interval (CI), 7.0-7.5], followed by septicemia (OR=4.1; 95% CI, 4.0-4.3), renal failure (OR=3.4; 95% CI, 3.3-3.5), and acute liver failure (OR=2.9; 95% CI, 2.7-3.0). On the basis of the major risk factors for mortality, a risk-adjusted model was developed that could predict the in-hospital outcome of hepatitis C patients with an accurate rate of 89.2%.
  
  
  CONCLUSIONS
  Despite decreasing in-hospital mortality, both hospital volume and charges related to hepatitis C increased from 2005 to 2011. Use of a risk-adjusted model could help predict mortality and improve outcomes of hepatitis C inpatients.
authors.affiliation: *Department of Internal Medicine ‡Section of Gastroenterology and Hepatology, University of Nevada School of Medicine †Infectious Disease Specialists, University Medical Center of Southern Nevada, Las Vegas, NV.
authors.forename: Ruihong
authors.initials: R
authors.lastname: Luo
authors.forename: Alan
authors.initials: A
authors.lastname: Greenberg
authors.forename: Christian D
authors.initials: CD
authors.lastname: Stone
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality; D005260:Female; D006526:Hepatitis C / Q000150:complications / Q000191:economics / Q000401:mortality*; D017722:Hospital Charges / Q000639:trends*; D017052:Hospital Mortality / Q000639:trends*; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006801:Humans; D007902:Length of Stay; D008103:Liver Cirrhosis / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012131:Respiratory Insufficiency / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D014481:United States / Q000453:epidemiology; D014600:Utilization Review