Wasuwanich Paul, So Joshua M, Sadek Mustafa, Jarasvaraparn Chaowapong, Rajborirug Songyos, Quiros-Tejeira Ruben E, Karnsakul Wikrom
Department of Internal Medicine, Naples Comprehensive Health, Naples, FL 34102, USA.
Department of Internal Medicine, University of Florida College of Medicine, Gainesville, FL 32610, USA.
Children (Basel). 2025 Jan 8;12(1):71. doi: 10.3390/children12010071.
BACKGROUND/OBJECTIVES: We aim to describe the changing inpatient epidemiology of NAFLD in the U.S. and identify major risk factors associated with mortality in the disease among hospitalized pediatric patients.
Hospitalization data from the 1998-2020 National Inpatient Sample were utilized. ICD-9 and ICD-10 codes were used to identify pediatric patients (age less than 18 years old) with NAFLD, and risk factors for mortality were analyzed by logistic regression.
We identified 68,869 pediatric hospitalizations involving NAFLD. Among those, 970 (1.4%) died during hospitalization. Hospitalization rates have been rapidly increasing from 1998 to 2020 (incidence rate ratio (IRR): 1.07; 95% CI: 1.06-1.07; < 0.001). There was a significant difference in mortality based on the type of hospital (rural, non-teaching urban, or teaching urban) in pediatric patients with NAFLD ( < 0.05). Coagulopathy was significantly associated with increased odds of mortality, while age ≥ 12 years, diabetes and obesity were associated with decreased odds of mortality ( < 0.05). Sex, race/ethnicity, hepatitis B, hepatitis C, HIV, and IV drug use were not significantly associated with mortality.
Our study has shown ever increasing hospitalization rates for NAFLD in pediatric populations and well as significant risk factors associated with mortality. Further studies should be performed as more data on this patient population are collected.
背景/目的：我们旨在描述美国非酒精性脂肪性肝病（NAFLD）住院患者流行病学的变化，并确定住院儿科患者中与该疾病死亡率相关的主要风险因素。
利用1998 - 2020年国家住院患者样本的住院数据。使用国际疾病分类第九版（ICD - 9）和第十版（ICD - 10）编码来识别患有NAFLD的儿科患者（年龄小于18岁），并通过逻辑回归分析死亡率的风险因素。
我们确定了68869例涉及NAFLD的儿科住院病例。其中，970例（1.4%）在住院期间死亡。从1998年到2020年，住院率一直在快速上升（发病率比（IRR）：1.07；95%置信区间：1.06 - 1.07；P < 0.001）。患有NAFLD的儿科患者中，根据医院类型（农村、非教学城市或教学城市）的死亡率存在显著差异（P < 0.05）。凝血障碍与死亡率增加的几率显著相关，而年龄≥12岁、糖尿病和肥胖与死亡率降低的几率相关（P < 0.05）。性别、种族/民族、乙型肝炎、丙型肝炎、艾滋病毒和静脉注射吸毒与死亡率无显著关联。
我们的研究表明，儿科人群中NAFLD的住院率不断上升，以及与死亡率相关的显著风险因素。随着收集到更多关于该患者群体的数据，应进行进一步的研究。
