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Clinical Characteristics, Comorbidities and Hospital Outcomes in Hospitalizations with Cyclic Vomiting Syndrome: A Nationwide Analysis

Digestive Diseases and Sciences volume 62, pages 2035–2044 (2017)Cite this article

Abstract

Background

Data on cyclic vomiting syndrome (CVS) are limited to studies from tertiary care centers. There is a paucity of information about CVS on a national scale.

Aim

To study the clinical characteristics, comorbidities, and hospital outcomes in patients hospitalized with CVS using a nationwide database.

Methods

We identified all hospitalizations associated with a primary diagnosis of CVS in 2010 and 2011 using the Nationwide Inpatient Sample with an age category of 18–55 years. A 1:2 random sample of non-CVS hospitalizations with the same age category was obtained, and comparisons between groups were made. Multivariate logistic regression analysis was used to determine comorbidities independently associated with CVS.

Results

Our study included 20,952 CVS and 44,262 non-CVS patients. CVS patients tended to be younger, male, and white compared to non-CVS patients. On multivariate analysis, CVS was significantly associated with comorbidities including dysautonomia, migraine, anxiety, marijuana use, irritable bowel syndrome, gastroparesis, gastroesophageal reflux disease, asthma, cigarette smoking, and hypertension. CVS patients underwent esophagogastroduodenoscopy, colonoscopy, and gastric emptying tests more frequently. They had more favorable hospital outcomes like more routine discharges (discharge to home/self-care), lower mortality, and shorter length of stay but tended to leave against medical advice more frequently. CVS patients incurred total hospital charges of about $400 million over the 2 years.

Conclusions

Our study showed that CVS is associated with several comorbidities and incurred substantial health care costs despite benign outcomes. Efforts to optimize therapy of CVS, manage comorbid conditions and reduce healthcare utilization are warranted.

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Acknowledgments

The authors acknowledge Aniko Szabo, Ph.D., of the Division of Biostatistics, Medical College of Wisconsin, for her assistance with the statistical analysis.

Authors’ contributions

SB was involved in concept, study design, data collection, statistical analysis, interpretation of results and drafting of the manuscript. TV was involved in concept, study design, interpretation of results and critical revisions to manuscript. Both the authors approved the final version of the article.

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Affiliations

  1. Division of General Internal Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Ave., Milwaukee, WI, 53226, USA

    Sanjay Bhandari

  2. Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI, USA

    Thangam Venkatesan

Authors
  1. Sanjay Bhandari
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  2. Thangam Venkatesan
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Correspondence to Sanjay Bhandari.

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Bhandari, S., Venkatesan, T. Clinical Characteristics, Comorbidities and Hospital Outcomes in Hospitalizations with Cyclic Vomiting Syndrome: A Nationwide Analysis. Dig Dis Sci 62, 2035–2044 (2017). https://doi.org/10.1007/s10620-016-4432-7

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  • DOI: https://doi.org/10.1007/s10620-016-4432-7

Keywords

  • Cyclic vomiting syndrome
  • Comorbidities
  • Nationwide Inpatient Sample
  • Procedures
  • Marijuana