Division of Pediatric Gastroenterology, Hepatology and Nutrition, Stanford University School of Medicine, 780 Welch Road, RM CJ250K, Palo Alto, CA, 94304, USA.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 780 Welch Road, RM CJ250K, Palo Alto, CA, 94304, USA.
Dig Dis Sci. 2021 Jul;66(7):2240-2249. doi: 10.1007/s10620-020-06530-w. Epub 2020 Aug 14.
Adult liver-related hospitalizations have recently increased in the USA, but data are limited for the pediatric population.
Utilizing the Office of Statewide Health Planning and Development hospital claims database (covering > 98% of all California hospitalizations), we aimed to characterize the demographic, clinical, and socioeconomic factors of liver disease-associated admissions among children between 2005 and 2015.
We used ICD-9 codes to identify admissions associated with liver disease in patients up to 21 years of age. Patient characteristics were described as percentages and evaluated using the χ test. We used linear regression to examine changes over time.
We analyzed 37,372 eligible admissions. Overall, close to one-third (28%) and one-half (48.0%) of admissions occurred in the age group 0-5 years and 16-21 years, respectively, with the remaining 23.1% occurring in the age group between 5 and 15 years. Over half (54.9%) were in males. By race, blacks made up half of the admission (49.7%), while by ethnicity, Hispanic also accounted for half of the admission (49.7%). Medicaid and Medicare payors were also disproportionately represented (54.6%). The most common liver disease was Alagille syndrome (29.2%) in 2005. Between 2005 and 2015, both the number of pediatric liver-associated admissions and the proportion of pediatric liver admissions over total admissions increased from 3130 to 3429 and 1.2% to 1.6%, respectively (both p = 0.001). By 2015, while Alagille syndrome admissions decreased to 26.4% (p = 0.004), NAFLD admission increased to 19.7% (p < 0.001).
Major disparities exist in inpatient liver disease burden for blacks and Hispanics with liver disease, while NAFLD emerged as a rapidly rising liver disease in pediatrics.
美国成人与肝脏相关的住院治疗最近有所增加，但针对儿科人群的数据有限。
利用州卫生规划与发展办公室的医院索赔数据库（涵盖加利福尼亚州所有住院治疗的 98%以上），我们旨在描述 2005 年至 2015 年间儿童肝脏疾病相关住院的人口统计学、临床和社会经济因素。
我们使用 ICD-9 代码来识别 21 岁以下患者中与肝脏疾病相关的住院治疗。描述患者特征的百分比，并使用 χ 检验进行评估。我们使用线性回归来检查随时间的变化。
我们分析了 37372 例符合条件的住院治疗。总体而言，近三分之一（28%）和一半（48.0%）的住院治疗发生在 0-5 岁和 16-21 岁年龄组，其余 23.1%发生在 5-15 岁年龄组。超过一半（54.9%）为男性。按种族划分，黑人占住院治疗的一半（49.7%），而按族裔划分，西班牙裔也占住院治疗的一半（49.7%）。医疗补助和医疗保险支付者也不成比例地代表（54.6%）。最常见的肝脏疾病是 Alagille 综合征（29.2%），在 2005 年。在 2005 年至 2015 年间，儿科肝脏相关住院治疗的数量和儿科肝脏住院治疗占总住院治疗的比例分别从 3130 例增加到 3429 例和从 1.2%增加到 1.6%（均 p=0.001）。到 2015 年，虽然 Alagille 综合征的住院治疗下降到 26.4%（p=0.004），但非酒精性脂肪性肝病的住院治疗增加到 19.7%（p<0.001）。
黑人及西班牙裔人群患肝脏疾病的住院治疗负担存在严重差异，而非酒精性脂肪性肝病已成为儿科肝脏疾病中迅速上升的疾病。
