Umer Farooq, MD1, Zahid Tarar, MD2, Chengu Niu, MD3, Abdallah El Alayli, MD1, Abu Fahad Abbasi, MD4, Umar Hayat, MD5, Ammad Chaudhary, MD6, Kamran Qureshi, MD1 1Saint Louis University, St. Louis, MO; 2University of Missouri, Columbia, MO; 3Rochester General Hospital, Rochester, NY; 4Loyola University Medical Center, Maywood, IL; 5Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; 6Henry Ford Hospital, Detroit, MI
Introduction: With growing prevalence of Nonalcoholic steatohepatitis (NASH) in general population, the complications of cirrhosis and co-morbid conditions, and rising awareness among the providers; the burden of NASH among hospitalized population is expected to rise. Our longitudinal study examines this trend along with patient and hospital characteristics of hospitalized patients with NASH.
Methods: We used the National Inpatient Sample (NIS 2016-2020) and employed ICD-10 codes to identify all adult hospitalizations with NASH. The age and gender-adjusted linear trends were obtained using the Mantel-Haenszel linear trend test. Stata v4.2 was used to perform analyses. Changes in various demographics were assessed and the findings were also validated using National Readmission Database (NRD).
Results: There were 539,274 hospitalizations among NASH adults from 2016 - 2020 (Table. 1). The number of hospitalizations of NASH patients increased from 85,424 in 2016 to 121,910 in 2020 (p< 0.01). The rise was noted to be significantly higher among Black and Hispanic (p< 0.05) but not in white population. The mean age slightly increased from 61.2 to 62.7 years over the study period (p< 0.01). The longitudinal trend of NASH diagnosis was noted to be increasing in patients with Medicaid. while a decline was noted in those with private insurance. The comorbidity burden (marked by the Charlson comorbidity index) in NASH patients increased over the years. NASH-related hospitalization increased in small bed-size hospitals (from 15.3% in 2016 to 18.7% in 2020), while not changing in medium and large hospitals. NASH was noted proportionally more in teaching center hospitalizations while it showed a decreasing trend at non-teaching hospitals. Upon validation of these findings using NRD, we noted similar trends for all patient and hospital characteristics.
Discussion: Hospitalizations with NASH are rising in the US. This rise is noted among Black and Hispanic population. The inpatient NASH population is noted to be older and sicker overtime. NASH is reported more frequently during hospitalization in smaller hospitals, and in academic centers. While this could reflect general rise in NASH prevalence, but also could signify a growing awareness among healthcare providers about NASH. Healthcare costs resulting from these hospitalizations are expected to rise, as a rise among NASH inpatients with Medicaid is noted. Efforts to promote early detection and management of NASH are imperative, so that hospitalizations are minimized.
Disclosures:
Umer Farooq indicated no relevant financial relationships.
Zahid Tarar indicated no relevant financial relationships.
Chengu Niu indicated no relevant financial relationships.
Abdallah El Alayli indicated no relevant financial relationships.
Abu Fahad Abbasi indicated no relevant financial relationships.
Umar Hayat indicated no relevant financial relationships.
Ammad Chaudhary indicated no relevant financial relationships.
