Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis

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  • McDonald, S.A. et al (2018) Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis

    Rights statement: This is the peer reviewed version of the following article: McDonald SA, Innes HA, Aspinall EJ, et al. Inpatient hospital burden of hepatitis C-diagnosed patients with decompensated cirrhosis. Liver Int. 2018;00:1-9., which has been published in final form at https://doi.org/10.1111/liv.13681. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.

    Accepted author manuscript, 571 KB, PDF-document

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Original languageEnglish
JournalLiver International
Early online date19 Jan 2018
DOIs
StateE-pub ahead of print - 19 Jan 2018

Abstract

Background & Aims: To describe the burden on inpatient hospital resources over time from patients diagnosed with hepatitis C virus (HCV) infection and who have reached the decompensated stage of cirrhosis (DC), as existing estimates of hospital stay in these patients are limited. Methods: A retrospective longitudinal dataset was formed via record-linkage between the national HCV diagnosis database and inpatient/daycase hospitalisation and death registers in Scotland. The study population consisted of HCV-diagnosed patients with a first DC admission in 1996-2013, with follow-up available until 31 May 2014. We investigated and quantified the mean cumulative length of hospital stay, distributions over discharge diagnosis categories, and trends in admission rates. Results: Among our study population (n=1543), we identified 10,179 admissions with any diagnosis post-first DC admission. Between 1996 and 2013 there was a 16-fold rise in annual total admissions (from 112 to 1791) and an 11-fold rise in hospital stay (719 to 8045). When restricting minimum possible follow-up to two years, DC patients (n=1312) had an overall admission rate of 7.3 per person-year, and spent on average 43 days (26 days during first 6 months) in hospital; for all liver-related, liver-related other than HCC/DC, and non-liver related only admissions, this was 39, 14, and 5 days, respectively. Conclusions: HCV-infected DC patients impose a considerable inpatient hospital burden, mostly from DC- and other liver-related admissions, but also from admissions associated with non-liver co-morbidities. Estimates will be useful for monitoring the impact of prevention and treatment, and for computing the cost-effectiveness of new therapies.

Keywords

  • Scotland; decompensated cirrhosis; hepatitis C virus; hospital stay