Real‐world clinical features, health‐care utilization, and economic burden in decompensated cirrhosis patients: A national database.

Lee, Hankil; Kim, Beom Kyung

Background: Patients with decompensated cirrhosis are well known to experience morbidity and mortality. Aim: We assessed clinical characteristics, health‐care utilization, and economic burden according to the type, number, and combination of decompensation‐related complications. Methods: We used recent nationally representative sample data from 2016 to 2018, covering approximately 13% of hospitalized patients in South Korea annually. Decompensation‐related complications included ascites, hepatic encephalopathy (HE), gastroesophageal variceal (GEV) bleeding, and hepatorenal syndrome (HRS). Results: Among 14 601 patients with decompensated cirrhosis, 11 201 (76.7%) experienced ≥ 1 decompensation‐related complications, and approximately three‐quarters underwent hospitalization. The most prevalent decompensation‐related complications were ascites (54.8%), GEV bleeding (33.2%), HE (27.4%), and HRS (3.6%). Patients with GEV bleeding exhibited the highest hospitalization rate (95.7%), and patients with HE or HRS underwent hospitalization for 4 weeks/year due to decompensated cirrhosis. Hospitalization costs were 1.9 times higher in patients with HRS than in those with ascites alone ($9022 vs $4673; P < 0.01). Once patients developed decompensation‐related complications, 41.3% had ≥ 2 types of decompensation‐related complications. As the number of decompensation‐related complications increased from 0 to ≥ 3, health‐care utilization and economic burden significantly increased in a stepwise manner; patients with ascites, GEV bleeding, and HE visited medical institutions 2.2 times more (11 vs 5/year; P < 0.01) and incurred 6.4 times greater medical expenditure ($11 060 vs $1728/year; P < 0.01) than those with ascites only. Conclusion: A substantial proportion of patients had multiple decompensation‐related complications and socioeconomic burdens for decompensated cirrhosis considering admission rate, hospital stay, and costs increased markedly, depending on the number of decompensation‐related complications.

SOUTH Korea; CIRRHOSIS of the liver; HEPATORENAL syndrome; HEPATIC encephalopathy; HOSPITAL patients; ASCITES

Journal of Gastroenterology & Hepatology, 2022, Vol 37, Issue 11, p2154

0815-9319

Academic Journal

10.1111/jgh.15962