Introduction

Approximately 30% of patients with a first acute pericarditis episode experience a recurrence ≤ 18 months; ~ 15% experience multiple recurrences. This study assessed the recurrence and economic burden among patients with multiple recurrences.

Methods

Adults with idiopathic pericarditis were identified in the OptumHealth Care Solutions, Inc., database (2007–2017). Recurrent pericarditis (RP) was defined as ≥ 2 episodes of care separated by > 28 days; multiple recurrences were defined as ≥ 2 recurrences.

Results

Among 944 patients with RP, 375 (39.7%) experienced multiple recurrences and were propensity score-matched 1:1 to 375 patients without recurrence. Among patients with multiple recurrences, median disease duration (time from first episode to end of last recurrence, confirmed by a 1.5-year recurrence-free period) was 2.84 years. The multiple recurrences cohort had higher rates of hospitalizations per-patient-per-month (PPPM) than the no recurrence cohort (rate ratio [95% confidence interval (CI)] = 2.22 [1.35–3.65]). Mean total healthcare costs were significantly higher in the multiple recurrences versus no recurrence cohort ($2728 vs. $1568 PPPM, cost ratio [95% CI] = 1.74 [1.29–2.32]), mainly driven by higher hospitalization costs in the multiple recurrences cohort (mean: $1180 vs. $420 PPPM, cost ratio [95% CI] = 2.81 [1.80–4.66]). Mean work loss costs were higher in the multiple recurrences versus no recurrence cohort ($696 vs. $169 PPPM, cost ratio [95% CI] = 4.12 [1.64–9.61]). In patients with multiple recurrences, mean cost of the first episode was $19,189; subsequent recurrences ranged from $2089 to $7366 (second recurrence = $6222).

Conclusion

In conclusion, among patients with multiple pericarditis recurrences, disease symptoms persisted several years, and healthcare and work loss costs were further compounded in this subset of patients.

中文翻译：

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美国私人保险人群中与复发性心包炎相关的疾病和经济负担

介绍

大约 30% 的首次急性心包炎发作的患者会在 ≤ 18 个月内复发；~ 15% 经历多次复发。本研究评估了多次复发患者的复发和经济负担。

方法

在 OptumHealth Care Solutions, Inc. 数据库（2007-2017 年）中确定了患有特发性心包炎的成人。复发性心包炎 (RP) 定义为 ≥ 2 次护理，间隔 > 28 天；多次复发被定义为≥2次复发。

结果

在 944 例 RP 患者中，375 例 (39.7%) 经历了多次复发，并且倾向评分匹配 1:1 至 375 例未复发的患者。在多次复发的患者中，中位病程（从第一次发作到最后一次复发结束的时间，由 1.5 年的无复发期证实）为 2.84 年。多次复发队列的每位患者每月住院率 (PPPM) 高于无复发队列（比率 [95% 置信区间 (CI)] = 2.22 [1.35–3.65]）。与未复发队列相比，多次复发队列的平均总医疗费用显着更高（2728 美元对 1568 美元 PPPM，成本比 [95% CI] = 1.74 [1.29-2.32]），主要是由于多次复发队列的住院费用较高（平均值：1180 美元对 420 美元 PPPM，成本比 [95% CI] = 2.81 [1.80–4.66]）。多次复发与无复发队列相比，平均工作损失成本更高（696 美元对 169 美元 PPPM，成本比 [95% CI] = 4.12 [1.64–9.61]）。在多次复发的患者中，首发的平均费用为 19,189 美元；随后的复发从 2089 美元到 7366 美元不等（第二次复发 = 6222 美元）。

结论

总之，在多发性心包炎复发的患者中，疾病症状持续数年，这部分患者的医疗保健和工作损失成本进一步增加。