Evidence map›Paper›PMID 30327963›Full record

ArticleDigestive diseases and sciences2019

Rising Inpatient Encounters and Economic Burden for Patients with Nonalcoholic Fatty Liver Disease in the USA.

Alexander L Nguyen, Haesuk Park, Pauline Nguyen, Edward Sheen, Yoona A Kim, Mindie H Nguyen

Abstract read
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In one paragraph

Article in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action.Diabetes spectrum : a publication of the American Diabetes Association · 2024
    Article
  7. Lifestyle interventions in nonalcoholic fatty liver disease.Nature reviews. Gastroenterology & hepatology · 2023
    Review
  8. Estimating the cost of illness of non-alcoholic fatty liver disease in Bangladesh.JGH open : an open access journal of gastroenterology and hepatology · 2023
    Article
  9. Nonalcoholic fatty liver disease and non-liver comorbidities.Clinical and molecular hepatology · 2023
    Review
  10. Article
  11. PMEnvironmental research · 2022
    Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Alexander L NguyenDivision of Gastroenterology and Hepatology, John H. Stroger Jr. Hospital of Cook County, 1900 W. Polk St. 14th Floor, Chicago, IL, 60612, USA.
Haesuk ParkCollege of Pharmacy, University of Florida, HPNP Room 3325, 1225 Center Dr, Gainesville, FL, 32601, USA.
Pauline NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Dr A160 MC 5309, Stanford, CA, 94305, USA.
Edward SheenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Dr A160 MC 5309, Stanford, CA, 94305, USA.
Yoona A KimDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Dr A160 MC 5309, Stanford, CA, 94305, USA.
Mindie H NguyenDivision of Gastroenterology and Hepatology, Stanford University Medical Center, 300 Pasteur Dr A160 MC 5309, Stanford, CA, 94305, USA. mindiehn@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNonalcoholic fatty liver disease (NAFLD) is the fastest-growing chronic liver disease. However, little is known about NAFLD inpatient resource utilization and clinical outcomes.

aimsThe aim of this study was to quantify inpatient NAFLD encounters using patient-level data over time.

methodsThis was a retrospective analysis of de-identified data for NAFLD patients from the California Patient Discharge Database from 2006 to 2013. NAFLD patients were identified by ICD9 codes 571.40, 571.41, 571.49, 571.8, and 571.9.

resultsNAFLD patients (n = 91,558) were predominantly female (60%), 45-65 years old (44%), and white (53%). Inpatient encounters increased from 8153 in 2006 to 16,457 in 2013 and were associated with a 207% increase in charges ($686 million in 2006 to $1.42 billion in 2013) and average increase in charges of 9.8% per year adjusting for inflation. Comorbidities (obesity, diabetes, hyperlipidemia, cardiovascular disease, other cancer, and renal disease) increased significantly over time (all P < 0.05). From 2006 to 2011, there were 11,463 deaths (1849 for liver-related hospitalizations) (mean follow-up 4.00 ± 2.13 years). The most significant predictors of death were age > 75 (aHR 3.9, P < 0.0001), male gender (aHR 1.10, P < 0.0001), white race (aHR 1.2, P < 0.0001), decompensated cirrhosis (aHR 2.1, P < 0.0001), and cancer other than HCC (aHR 3.2, P < 0.0001). Within the liver-related hospitalization cohort, mortality predictors were similar, except for Hispanic race (aHR 0.92, P < 0.0096) and renal disease (aHR 1.50, P < 0.0001).

conclusionsThe number of NAFLD inpatient encounters increased significantly from 2006 to 2013, as did the inflation-adjusted inpatient charges. The most significant predictors of death were non-liver cancers (HR 3.11, P < 0.0001, CI 3.06-3.16) and age > 75 years (HR 3.94, P < 0.0001, HR 3.86-4.03).

Indexed as

Cost of IllnessHealth ExpendituresHospital ChargesHospital CostsInpatientsAdolescentAdultAgedAge FactorsCaliforniaComorbidityDatabases, FactualFemaleHumansMaleMiddle AgedEconomic burden of NAFLDNAFLDNAFLD comorbidities and mortalityNAFLD inpatient hospitalizations

Identifiers

PMID30327963

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.