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Chronic liver disease hospitalizations outpace other chronic diseases

Patients with chronic liver disease had increasing rates of hospitalization, longer hospital stay, more readmissions and less access to post-acute care compared with patients with other chronic diseases, according to a recently published study.

“There has been a steady increase in the burden of chronic diseases among patients seeking inpatient care in the U.S. and worldwide,” Sumeet K. Asrani, MD, MSc, from the Baylor University Medical Center in Texas, and colleagues wrote. “Though certain trends are reassuring (length of stay and inpatient mortality reduction), disease management models are sorely needed to mitigate the increasing burden of hospitalization and readmission trends in CLD.”

Asrani and colleagues gathered adult patient data from 2004 to 2013 to compare CLD-related hospitalizations vs. hospitalizations related to congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD).

CLD hospitalization rates increased from 1,295 per 100,000 in 2004 to 2,490 per 100,000 in 2013, representing a 92% increase compared with an increase of 48.8% in COPD and 6.7% in CHF.

The standard hospitalization rate was significant in both CLD (SHR = 1.64; P = .0002) and COPD (SHR = 1.26; P = .0006), whereas CHF demonstrated a downward trend (SHR = –2.13; P < .0001).

In 2013, patients with CLD had significantly higher rates of inpatient mortality and disposition to hospice (14.2%; P < .01) compared with CHF (11.5%) and COPD (9.3%) following hospitalization. They also had significantly higher readmission rates at 30 days (25%; P < .01) compared with patients hospitalized for CHF (21.9%) or COPD (20.6%).

At discharge, patients with CLD were significantly less likely to receive ancillary services such as skilled nursing facilities, rehabilitation or home health (13.2%; P < .01) compared with CHF (27.4%) and COPD (23.2%).

“It is important to put our results of increasing burden in the context of other chronic resource intensive conditions,” the researchers wrote. “CHF and COPD are appropriate comparators given that, similar to CLD, they are manifestations of end organ damage for their respective organs and have a significant source of their morbidity reflected in inpatient burden. These data highlight the need to adapt lessons learnt from successful management of other chronic diseases such as CHF and COPD to mitigate the increasing CLD-related burden.” – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.