Sarvepalli S, Garg S K, Sarvepalli S S, Parikh M P, Wadhwa V, Jang S, Thota P N, Sanaka M R
Department of Hospital Medicine, Medicine Institute.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.
Dis Esophagus. 2018 Sep 1;31(9). doi: 10.1093/dote/doy022.
Esophageal cancer (EC) continues to be a major source of morbidity and mortality in the United States. However, there has been a relative dearth of research into hospital utilization in patients with EC. This study examines temporal trends in hospital admissions, length of stay (LOS), mortality, and costs associated with EC. In addition, we also analyzed factors associated with inpatient mortality and LOS. We interrogated National Inpatient Sample (NIS), a large registry of inpatient data, to retrieve information about various demographic and factors associated with hospital stay in patients who were admitted for EC between the years 1998 and 2013 in the United States. After examining trends over time, multivariate analysis was performed to identify factors associated with LOS and mortality. During 1998-2013, 538,776 hospital stays with principal diagnosis of EC were reviewed. Number of hospital stays and inpatient charges increased by 397 per year (±67.8; P < 0.0001) and $3,033 per patient per year (±135; <0.0001) respectively. Mortality and LOS decreased by 0.23% per year (±0.03; P < 0.0001) and 0.07 days per year (±0.006; P < 0.0001) respectively. Multiple factors associated with LOS and mortality were outlined. Despite overall increase in hospital utilization with respect to number of admissions and inpatient charges, inpatient mortality and LOS associated with EC declined. Factors associated with inpatient mortality and LOS may help drive clinical decision-making and influence healthcare or hospital policy.
食管癌（EC）在美国仍然是发病和死亡的主要原因。然而，针对食管癌患者的医院利用情况的研究相对较少。本研究调查了食管癌患者的住院时间趋势、住院时长（LOS）、死亡率以及相关费用。此外，我们还分析了与住院死亡率和住院时长相关的因素。我们查询了国家住院样本（NIS），这是一个大型住院患者数据登记库，以获取1998年至2013年间在美国因食管癌入院患者的各种人口统计学信息以及与住院相关的因素。在研究了随时间的趋势后，进行了多变量分析以确定与住院时长和死亡率相关的因素。在1998 - 2013年期间，共审查了538,776例以食管癌为主要诊断的住院病例。住院次数和住院患者费用分别以每年397次（±67.8；P < 0.0001）和每位患者每年3,033美元（±135；<0.0001）的速度增长。死亡率和住院时长分别以每年0.23%（±0.03；P < 0.0001）和每年0.07天（±0.006；P < 0.0001）的速度下降。概述了与住院时长和死亡率相关的多个因素。尽管在入院次数和住院患者费用方面医院利用总体有所增加，但与食管癌相关的住院死亡率和住院时长却有所下降。与住院死亡率和住院时长相关的因素可能有助于推动临床决策制定并影响医疗保健或医院政策。
