Journal article
Associated comorbidities, healthcare utilization & mortality in hospitalized patients with haemophilia in the United States: Contemporary nationally representative estimates
Haemophilia : the official journal of the World Federation of Hemophilia, Vol.28(4), pp.532-541
07/2022
DOI: 10.1111/hae.14557
PMCID: PMC9540439
PMID: 35412659
Abstract
Current in-hospital burden and healthcare utilization patterns for persons with haemophilia (PWH) A and B, including both children (ages < 18 years) and adults (ages ≥ 18 years), in the United States (US) are lacking.
To evaluate healthcare utilization, the prevalence of comorbidities, and mortality in hospitalized paediatric and adult PWH using a contemporary nationally representative cohort.
Hospitalizations of PWH either as the primary reason for admission (principal diagnosis) or one of all listed diagnoses were identified using ICD-10 codes from the 2017 Nationwide Inpatient Sample (NIS), the largest publicly available all-payer inpatient discharge database in the US. Sampling weights were applied to generate nationally representative estimates.
The contemporary cohort included 10,555 hospitalizations (paediatrics, 18.3%; adults, 81.7%) among PWH as one-of-all listed diagnoses (n = 1465 as principal diagnosis). Median age (interquartile range) was 46 (24-66) years overall; adults, 54 (35-70) years and paediatric, 4 (1-11). The most common comorbidities in adults were hypertension (33.4%), hyperlipidaemia (23.6%), and diabetes (21.1%). In children, hemarthrosis (11.4%), contusions (9.6%), and central line infections (9.3%) were the most common. The overall mortality rate was 2.3%. Median hospital charges per haemophilia admission were $52,616 ($24,303-$135,814) compared to $26,841 ($12,969-$54,568) for all-cause admissions in NIS.
Bleeding and catheter-related infections are the significant reasons for paediatric haemophilia admissions. Adult haemophilia admissions tend to be associated with age-related comorbidities. Costs for haemophilia-related hospitalizations are higher than the national average for all-cause hospitalizations.
Details
- Title: Subtitle
- Associated comorbidities, healthcare utilization & mortality in hospitalized patients with haemophilia in the United States: Contemporary nationally representative estimates
- Creators
- Jonathan R Day - Southern Illinois University School of MedicineClifford Takemoto - St. Jude Children's Research HospitalAnjali Sharathkumar - Roy J. and Lucille A. Carver College of MedicineSarah Makhani - FIU Herbert Wertheim College of MedicineAshwin Gupta - Vanderbilt UniversityStephanie Bitner - Southern Illinois University School of MedicineCassandra D Josephson - Emory UniversityEvan M Bloch - Johns Hopkins UniversityAaron A R Tobian - Johns Hopkins UniversityLakshmanan Krishnamurti - Yale UniversityRuchika Goel - Southern Illinois University School of Medicine
- Resource Type
- Journal article
- Publication Details
- Haemophilia : the official journal of the World Federation of Hemophilia, Vol.28(4), pp.532-541
- DOI
- 10.1111/hae.14557
- PMID
- 35412659
- PMCID
- PMC9540439
- NLM abbreviation
- Haemophilia
- ISSN
- 1351-8216
- eISSN
- 1365-2516
- Grant note
- R38 HL150208 / NHLBI NIH HHS P30 CA086862 / NCI NIH HHS
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Stead Family Department of Pediatrics; Hematology/Oncology
- Record Identifier
- 9984353939902771
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