Alukal Joseph J, Zhang Talan, Thuluvath Paul Joseph
Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, MD 21202, United States.
World J Hepatol. 2021 Jun 27;13(6):686-698. doi: 10.4254/wjh.v13.i6.686.
The Budd Chiari syndrome (BCS) is a rare and potentially fatal disease, but there is a paucity of data on the in- hospital mortality as well its economic burden on the health care system.
To evaluate trends in mortality, length of hospital stays and resource utilization among inpatients with BCS.
Data on all adult patients with a diagnosis of BCS were extracted from the National Inpatient Sample (NIS) from 1998 to 2017. To make inferences regarding the national estimates for the total number of BCS discharges across the study period, sample weights were applied to each admission per recommendations from the NIS.
During the study period, there were 3591 (8.73%) in-patient deaths. The overall in-hospital mortality rates among BCS patients decreased from 18% in 1998 to 8% in 2017; the mortality decreased by 4.41% ( < 0.0001) every year. On multivariate analysis, older age, higher comorbidity score, acute liver failure, acute kidney injury, acute respiratory failure, hepatic encephalopathy, hepatorenal syndrome, inferior vena cava thrombosis, intestinal infarct, sepsis/septic shock and cancer were associated increased risk of mortality. The average of length of stay was 8.8 d and it consistently decreased by 2.04% (95%CI: -2.67%, -1.41%, < 0.001) from 12.7 d in 1998 to 7.6 d in 2017.The average total charges after adjusted for Medical Care Consumers Price Index to 2017 dollars during the time period was $94440 and the annual percentage change increased by 1.15% (95%CI: 0.35%, 1.96%, = 0.005) from $95515 in 1998 to $103850 in 2017.
The in-hospital mortality rate for patients admitted with BCS in the United States has reduced between 1998 and 2017 and this may a reflection of better management of these patients.
布加综合征（BCS）是一种罕见且可能致命的疾病，但关于其住院死亡率以及对医疗保健系统的经济负担的数据却很少。
评估布加综合征住院患者的死亡率、住院时间和资源利用趋势。
从1998年至2017年的国家住院患者样本（NIS）中提取所有诊断为布加综合征的成年患者的数据。为了推断整个研究期间布加综合征出院总数的全国估计数，根据NIS的建议，对每次入院应用样本权重。
在研究期间，有3591例（8.73%）住院死亡病例。布加综合征患者的总体住院死亡率从1998年的18%降至2017年的8%；死亡率每年下降4.41%（<0.0001）。多因素分析显示，年龄较大、合并症评分较高、急性肝衰竭、急性肾损伤、急性呼吸衰竭、肝性脑病、肝肾综合征、下腔静脉血栓形成、肠梗死、败血症/脓毒性休克和癌症与死亡风险增加相关。平均住院时间为8.8天，从1998年的12.7天持续下降至2017年的7.6天，下降了2.04%（95%CI：-2.67%，-1.41%，<0.001）。在此期间，经医疗消费者价格指数调整至2017年美元后的平均总费用为94440美元，年百分比变化从1998年的95515美元增加至2017年的103850美元，增加了1.15%（95%CI：0.35%，1.96%，P=0.005）。
1998年至2017年期间，美国布加综合征住院患者的死亡率有所降低，这可能反映了对这些患者的管理有所改善。
