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Hyponatremia-Associated Healthcare Burden Among US Patients Hospitalized for Cirrhosis

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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.

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Author information

Authors and Affiliations

  1. Ochsner Medical Center, 1514 Jefferson Hwy., New Orleans, LA, 70121, USA

    Steven Deitelzweig

  2. University of California, Irvine, UCIMC, 101 The City Drive South, Building 58, Room 110, ZC-4076H, Mail Code: 4076, Irvine, CA, 92868, USA

    Alpesh Amin

  3. Otsuka America Pharmaceutical, Inc., 100 Overlook Center, Princeton, NJ, 08540, USA

    Rudell Christian & Keith Friend

  4. Novosys Health. 7 Crestmont Ct., Flemington, NJ, 08822, USA

    Jay Lin

  5. Premier Inc., 13034 Ballantyne Corporate Place, Charlotte, NC, 28277, USA

    Timothy J. Lowe

Authors
  1. Steven Deitelzweig
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  2. Alpesh Amin
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  3. Rudell Christian
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  4. Keith Friend
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  5. Jay Lin
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Correspondence to Steven Deitelzweig.

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Deitelzweig, S., Amin, A., Christian, R. et al. Hyponatremia-Associated Healthcare Burden Among US Patients Hospitalized for Cirrhosis. Adv Therapy 30, 71–80 (2013). https://doi.org/10.1007/s12325-012-0073-1

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