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Advances in Therapy

, Volume 30, Issue 1, pp 71–80 | Cite as

Hyponatremia-Associated Healthcare Burden Among US Patients Hospitalized for Cirrhosis

  • Steven Deitelzweig
  • Alpesh Amin
  • Rudell Christian
  • Keith Friend
  • Jay Lin
  • Timothy J. Lowe
Original Research

Abstract

Introduction

Hyponatremia is a frequent comorbid condition of patients hospitalized for cirrhosis and a predictor of disease severity and mortality. This study evaluated the healthcare burden of hyponatremia among patients hospitalized for cirrhosis in the real world.

Methods

Hyponatremic (HN) patients (>-18 years of age) with cirrhosis were identified using the Premier Hospital Database (January 1, 2007 to March 31, 2010) and matched to non-HN patients with cirrhosis using a combination of exact patient characteristics and propensity score matching. Univariate and multivariate statistics were utilized to compare hospital resource utilization, cost, and 30-day hospital re-admission among patient cohorts.

Results

The study population included 21,864 subjects (HN 10,932; non-HN 10,932). The hospital length of stay (LOS) (7.63 ± 7.4 vs. 5.89 ± 6.2 days; P < 0.001), hospital cost ($13,842 ± $20,702 vs. $11,140 ± $20,562; P < 0.001), intensive care unit (ICU) LOS (4.58 ± 4.7 vs. 3.59 ± 4.4 days; P < 0.001), and ICU cost ($7,038 ± $7,781 vs. $5,360 ± $7,557; P < 0.001) were greater for the HN cohort, as was the 30-day re-admission rate (all cause: 31.1% vs. 24.8%; P < 0.001; hyponatremia related: 25.1% vs. 11.0%; P < 0.001). Multivariate analysis showed that hyponatremia was associated with a 29.5% increase in hospital LOS, a 26.6% increase in overall hospital cost, a 23.2% increase in S. ICU LOS, and a 28.6% increase in ICU cost. Additionally, hyponatremia was associated with an increased risk of 30-day hospital re-admission (all cause: odds ratio [OR] 1.37; confidence interval [CI] 1.28-1.46; P < 0.001; hyponatremia related: OR 2.68; CI 2.48-2.90; P < 0.001).

Conclusion

Hyponatremia in patients with cirrhosis is a predictor of increased hospital resource use and 30-day hospital re-admission, and represents a potential target for intervention to reduce healthcare expenditures for patients hospitalized for cirrhosis.

Keywords

Cirrhosis Gastroenterology Healthcare costs Healthcare resource utilization Hyponatremia Length of stay Re-admission 

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Copyright information

© Springer Healthcare 2012

Authors and Affiliations

  • Steven Deitelzweig
    • 1
  • Alpesh Amin
    • 2
  • Rudell Christian
    • 3
  • Keith Friend
    • 3
  • Jay Lin
    • 4
  • Timothy J. Lowe
    • 5
  1. 1.Ochsner Medical CenterNew OrleansUSA
  2. 2.University of California, IrvineUCIMCIrvineUSA
  3. 3.Otsuka America Pharmaceutical, Inc.PrincetonUSA
  4. 4.Novosys Health. 7 Crestmont Ct.FlemingtonUSA
  5. 5.Premier Inc.CharlotteUSA

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