INTRODUCTION The prevalence of cirrhosis is increasing despite advances in therapeutics, and it remains an expensive medical condition. Studies examining the healthcare burden of inpatient cirrhosis-related care regardless of etiology, stage, or severity are lacking. This study aims to describe the current drivers of cost, length of stay (LOS), and mortality in hospitalized patients with cirrhosis. METHODS Using the National Inpatient Sample (NIS) data from 2008 to 2014, we categorized admissions into decompensated cirrhosis (DC), compensated cirrhosis (CC), and NIS without cirrhosis. Descriptive statistics and regression analysis were used to analyze the association between patient characteristics, comorbidities, complications, and procedures with costs, LOS, and mortality in each group. RESULTS The hospitalization costs for patients with cirrhosis increased 30.2% from 2008 to 2014 to $7.37 billion. Cirrhosis admissions increased by 36% and 24% in the DC and CC groups, respectively, compared with 7.7% decrease in the NIS without cirrhosis group. DC admissions contributed to 58.6% of total cirrhotic admissions by 2014. Procedures increased costs in both DC and CC groups by 15%-152%, with mechanical ventilation being associated with high cost increase and mortality increase. Complications are also key drivers of costs and LOS, with renal and infectious complications being associated with the highest increases in the DC group and infections and nonportal hypertensive gastrointestinal bleeding for the CC group. DISCUSSION Economic burden of hospitalized patients with cirrhosis is increasing with more admissions and longer LOS in DC and CC groups. Important drivers include procedures and portal hypertensive and nonportal hypertensive complications.

中文翻译：

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住院肝硬化患者的经济负担增加：国家数据库的分析。

引言尽管治疗方法有所进步，但肝硬化的患病率仍在上升，并且它仍然是一种昂贵的医学疾病。缺乏对病因，分期或严重程度进行肝硬化相关治疗的医疗负担的研究。这项研究的目的是描述目前住院肝硬化患者的成本，住院时间（LOS）和死亡率的驱动因素。方法使用2008年至2014年的全国住院患者样本（NIS）数据，将住院患者分为失代偿性肝硬化（DC），代偿性肝硬化（CC）和无肝硬化的NIS。描述性统计和回归分析用于分析患者特征，合并症，并发症和手术与费用，LOS和死亡率之间的关联。结果肝硬化患者的住院费用从2008年到2014年增加了30.2％，达到73.7亿美元。DC组和CC组的肝硬化入院率分别增加了36％和24％，而无肝硬化组的NIS则下降了7.7％。到2014年，DC入院占肝硬化总入院的58.6％。DC和CC组的手术费用增加了15％-152％，机械通气导致费用增加和死亡率增加。并发症也是成本和LOS的主要驱动因素，而肾脏和感染性并发症与DC组的最高增加以及CC组的感染和非门脉高压性胃肠道出血相关。讨论随着DC和CC组住院人数的增加和LOS时间的延长，住院肝硬化患者的经济负担正在增加。重要的驱动因素包括手术以及门脉高压和非门脉高压并发症。