理清美国心脏淀粉样变性住院治疗的临床和经济负担。
Untangling the clinical and economic burden of hospitalization for cardiac amyloidosis in the United States.
作者信息
Quock Tiffany P, Yan Tingjian, Tieu Ryan, D'Souza Anita, Broder Michael S
机构信息
Medical Affairs, Prothena Biosciences Inc, South San Francisco, CA, USA.
Health Services Research, Partnership for Health Analytic Research, LLC, Beverly Hills, CA, USA.
出版信息
Clinicoecon Outcomes Res. 2019 Jul 15;11:431-439. doi: 10.2147/CEOR.S207127. eCollection 2019.
PURPOSE
Cardiac dysfunction is common in amyloid light-chain (AL) amyloidosis, a rare disease caused by extracellular deposition of misfolded immunoglobulin light chains. This study aimed to examine economic/clinical disease burden in hospitalized cardiac amyloidosis patients.
PATIENTS AND METHODS
Cardiac amyloidosis patients ≥18 years old hospitalized between 2014 and 2016 were identified in claims if they had ≥1 inpatient claim consistent with amyloidosis and evidence of cardiac dysfunction. Descriptive statistics were reported.
RESULTS
3239 cardiac amyloidosis patients [1795 (55.4%) with concurrent renal disease] were identified. Mean (SD) length of stay was 8.3 (11.1) days. 25.2% were admitted to the intensive care unit. Mean overall hospitalization costs were USD$20,584. In-hospital mortality was 9.0% overall. 16.8% were readmitted within 30 days, with 11.2% dying in-hospital and a mean readmission cost of USD$18,536.
CONCLUSION
Hospitalization for cardiac amyloidosis is costly, with high rates of readmission and mortality. Opportunities exist to improve care.
目的
心脏功能障碍在轻链型（AL）淀粉样变性中很常见，这是一种由错误折叠的免疫球蛋白轻链细胞外沉积引起的罕见疾病。本研究旨在调查住院心脏淀粉样变性患者的经济/临床疾病负担。
患者与方法
在2014年至2016年期间住院的年龄≥18岁的心脏淀粉样变性患者，若其有≥1次与淀粉样变性相符的住院申请且有心脏功能障碍的证据，则从申请中识别出来。报告描述性统计数据。
结果
共识别出3239例心脏淀粉样变性患者[1795例（55.4%）合并肾脏疾病]。平均（标准差）住院时间为8.3（11.1）天。25.2%的患者入住重症监护病房。平均总住院费用为20,584美元。总体住院死亡率为9.0%。16.8%的患者在30天内再次入院，其中11.2%在住院期间死亡，再次入院的平均费用为18,536美元。
结论
心脏淀粉样变性的住院治疗成本高昂，再入院率和死亡率都很高。存在改善护理的机会。
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