title: Healthcare utilization and costs associated with cholangiocarcinoma.
abstract: Cholangiocarcinoma is a rare but devastating malignancy associated with a poor prognosis and a high mortality rate. With the recent advances in detection and treatment, it is unclear if the incidence and outcomes of cholangiocarcinoma are improving in the United States. The aim of this study was to evaluate the trends in the incidence, costs and mortality rates of cholangiocarcinoma- related hospital admissions in the USA.
  
  
  
  We utilized the National Inpatient Sample Database (NIS) from 1997-2012 for all patients in whom cholangiocarcinoma (ICD-9 code 155.1, 156) was the principal discharge diagnosis. The temporal trends in the number of hospital admissions, length of stay and, hospitalization costs along with mortality rates over the study period were determined by using regression analysis for trends.
  
  
  
  There was a significant increase in the number of hospital admissions for cholangiocarcinoma as the principal diagnosis from 1997 to 2012 (10 357 vs 11 970, P<0.001). The mean length of stay for cholangiocarcinoma decreased by 17 % between 1997 and 2012 from 9.5 days to 7.9 days (P<0.001). However, during the same period, the mean hospital charges per patient (adjusted for inflation) increased 113.25% from $36 460 in 1997 to $77 753 in 2012. The in-hospital mortality rate decreased from 9.3% in 1997 to 6.4% in 2012 (P<0.001).
  
  
  
  There was a significant increase in the number of hospital admissions and associated costs from cholangiocarcinoma in the USA between 1997 and 2012. However, this was accompanied by a decrease in the inpatient mortality rates from cholangiocarcinoma.
authors: Department of Internal Medicine, Fairview Hospital, Cleveland Clinic, Cleveland, Ohio.
authors: Vaibhav
authors: V
authors: Wadhwa
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Ohio.
authors: Yash
authors: Y
authors: Jobanputra
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Ohio.
authors: Prashanthi N
authors: PN
authors: Thota
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Ohio.
authors: K V
authors: KV
authors: Narayanan Menon
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Ohio.
authors: Mansour A
authors: MA
authors: Parsi
authors: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Ohio sanakam@ccf.org.
authors: Madhusudhan R
authors: MR
authors: Sanaka
keywords: cholangiocarcinoma; epidemiology; hospital charges; in-hospital mortality; inpatient admissions