title: Population Based Trends in the Incidence of Hospital Admission for the Diagnosis of Hepatorenal Syndrome: 1998-2011.
abstract: Background and Objectives. Hepatorenal syndrome carries a high risk of mortality. Understanding the incidence and mortality trends in hepatorenal syndrome will help inform future studies regarding the safety and efficacy of potential therapeutic interventions. Design and Methods. We conducted a retrospective cohort study using the Nationwide Inpatient Sample. We identified hospitalizations from January 1998-June 2011 with a primary diagnosis of hepatorenal syndrome. To characterize the incidence trends in monthly hepatorenal syndrome hospitalizations, we fit a piecewise linear model with a change point at January 2008. We examined hospital and patient characteristics before and after the change point. Results. Hospital admissions with a diagnosis of hepatorenal syndrome increased markedly between September of 2007 and March of 2008. Comparing patients who were admitted with a diagnosis of hepatorenal syndrome prior to 2008 with those after 2008, we found that length of stay increased while the mortality of patients admitted for hepatorenal syndrome decreased. Conclusion. The revision of the diagnostic criteria for hepatorenal syndrome may have contributed to the increase in the incidence of admissions for hepatorenal syndrome. However, the changes in the principles of hepatorenal syndrome management may have also contributed to the increase in incidence and lower mortality.
authors.affiliation: Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: Manish
authors.initials: M
authors.lastname: Suneja
authors.affiliation: Department of Biostatistics, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Fan
authors.initials: F
authors.lastname: Tang
authors.affiliation: Department of Biostatistics, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cavanaugh
authors.affiliation: Department of Pharmacy Practice and Science, University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Linnea A
authors.initials: LA
authors.lastname: Polgreen
authors.affiliation: Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Polgreen