title: Predictors of Inpatient Mortality and Resource Utilization for the Elderly Patients With Chronic Hepatitis C (CH-C) in the United States.
abstract: New incidents of chronic hepatitis C (CH-C) have stabilized yet the full impact of CH-C is not realized.Assess inpatient mortality and resource utilization for CH-C patients hospitalized in the United States.Adult CH-C patients were identified from The National Inpatient Sample (NIS) 2005 to 2009 database using the International Classification of Disease, Ninth Revision (ICD-9) diagnosis codes (070.51, 070.54, 070.70, 070.71, 070.41, and 070.44) also used to identify comorbidities.324,823 hospitalized CH-C patients were identified. Of these, 13.63% (N = 44,288) were older than 65. The rate of hospitalization for the elderly cohort steadily increased over the study period with Medicare as the payer for the majority (86%). This cohort had higher inpatient charges, approximately a half day longer hospital stay (P < 0.001) and more moderate or severe illness. During the index hospitalization, older CH-C patients were twice more likely to die than the younger age-group (5% versus 2%, P < 0.001). In the adjusted model, older age (OR: 1.02 [95% CI, 1.02-1.03]), severity of illness (OR: 12.06 [95% CI, 10.68-13.62]), and number of diagnoses (OR: 1.10 [95% CI, 1.09-1.11]) were associated with higher in-hospital mortality; severity of illness and having private insurance were significantly associated with charge per hospital stay (P < 0.001).The number of CH-C patients 65 and older increased due to the aging of the baby boomer population. Early treatment of CH-C patients with highly effective, well-tolerated, new anti-HCV regimens may prevent this significant societal burden.
authors.affiliation: From the Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA (PG, MO, WS, ABK, BN, ZMY); and Center for Liver Diseases, Department of Medicine, Inova Fair Falls Church, VA (WS, ZMY).
authors.forename: Pegah
authors.initials: P
authors.lastname: Golabi
authors.forename: Munkhzul
authors.initials: M
authors.lastname: Otgonsuren
authors.forename: Winnie
authors.initials: W
authors.lastname: Suen
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Koenig
authors.forename: Bashir
authors.initials: B
authors.lastname: Noor
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005260:Female; D019698:Hepatitis C, Chronic / Q000401:mortality* / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D014481:United States / Q000453:epidemiology; D055815:Young Adult
references.citation: Curr Gastroenterol Rep. 2010 Feb;12(1):1-6
references.pmid: 20425478
references.citation: J Clin Gastroenterol. 2015 Aug;49(7):620-7
references.pmid: 25203363
references.citation: Hepatology. 2015 Mar;61(3):776-82
references.pmid: 25179527
references.citation: J Viral Hepat. 2015 Feb;22(2):137-45
references.pmid: 24813350
references.citation: Dig Dis Sci. 2007 Oct;52(10):2531-9
references.pmid: 17406828
references.citation: CMAJ Open. 2014 Jul 22;2(3):E139-44
references.pmid: 25295233
references.citation: Ann Intern Med. 2006 May 16;144(10):705-14
references.pmid: 16702586
references.citation: Ann Intern Med. 2003 Nov 18;139(10):817-23
references.pmid: 14623619
references.citation: J Gastroenterol Hepatol. 2015 Feb;30(2):364-71
references.pmid: 25088088
references.citation: BMC Infect Dis. 2014 Oct 10;14:536
references.pmid: 25300638
references.citation: PLoS One. 2013 May 21;8(5):e63959
references.pmid: 23704962
references.citation: Health Aff (Millwood). 2014 Oct;33(10):1728-35
references.pmid: 25288416
references.citation: Am J Transplant. 2005 Feb;5(2):307-13
references.pmid: 15643990
references.citation: J Am Geriatr Soc. 1999 Sep;47(9):1110-3
references.pmid: 10484255
references.citation: Arch Intern Med. 2011 Feb 14;171(3):242-8
references.pmid: 21325115
references.citation: Liver Transpl. 2003 Apr;9(4):331-8
references.pmid: 12682882
references.citation: Am J Gastroenterol. 2012 May;107(5):691-7
references.pmid: 22290404
references.citation: Am J Transplant. 2006;6(5 Pt 2):1170-87
references.pmid: 16613594
references.citation: Hepatology. 2012 Jun;55(6):1652-61
references.pmid: 22213025
references.citation: Dig Liver Dis. 2007 Sep;39 Suppl 1:S4-7
references.pmid: 17936222
references.citation: QJM. 2009 Mar;102(3):193-202
references.pmid: 19147657
references.citation: Am J Gastroenterol. 2006 Jun;101(6):1260-7
references.pmid: 16771947
references.citation: Aliment Pharmacol Ther. 2013 Nov;38(9):1065-75
references.pmid: 24028331
references.citation: J Manag Care Pharm. 2013 Jul-Aug;19(6):438-47
references.pmid: 23806057
references.citation: Dig Dis Sci. 2002 Dec;47(12):2674-81
references.pmid: 12498284
references.citation: Clin Infect Dis. 2014 Sep 15;59(6):755-64
references.pmid: 24917659
references.citation: J Clin Gastroenterol. 2011 Feb;45(2):e17-24
references.pmid: 20628308
references.citation: Hepatology. 2008 Apr;47(4):1128-35
references.pmid: 18318441
references.citation: Aliment Pharmacol Ther. 2009 Sep 1;30(5):469-76
references.pmid: 19508612
references.citation: BMJ Open. 2014 May 16;4(5):e004318
references.pmid: 24838722
references.citation: Hepatology. 2009 Apr;49(4):1335-74
references.pmid: 19330875
references.citation: Aliment Pharmacol Ther. 2007 Feb;25 Suppl 1:3-9
references.pmid: 17295846
references.citation: J Hepatol. 2013 Aug;59(2):257-64
references.pmid: 23523582
references.citation: Aliment Pharmacol Ther. 2014 Mar;39(5):518-31
references.pmid: 24461160
references.citation: Dig Dis Sci. 2015 Feb;60(2):320-32
references.pmid: 25108520
references.citation: J Viral Hepat. 2010 May;17(5):360-6
references.pmid: 19758274
references.citation: MMWR Surveill Summ. 2008 Mar 21;57(2):1-24
references.pmid: 18354374
references.citation: Hepatology. 2005 Dec;42(6):1406-13
references.pmid: 16317670
references.citation: Clin Gastroenterol Hepatol. 2007 Sep;5(9):1092-9
references.pmid: 17625983