The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study).
<h4>Background & aims</h4>Hepatitis C (HCV) is associated with several extrahepatic manifestations, and estimates of the hospitalization burden related to these comorbidities are still limited. The aim of this study is to quantify the hospitalization risk associated with comorbiditie...
Main Authors: | , , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Public Library of Science (PLoS)
2019-01-01
|
Series: | PLoS ONE |
Online Access: | https://doi.org/10.1371/journal.pone.0219396 |
id |
doaj-b7594082c36849a1bd2ce842956257c1 |
---|---|
record_format |
Article |
spelling |
doaj-b7594082c36849a1bd2ce842956257c12021-03-04T10:28:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-01147e021939610.1371/journal.pone.0219396The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study).Simona CammarotaAnna CitarellaAntonella GuidaValeria ContiTeresa IannacconeMaria Elena FlaccoFrancesca BraviCristina NaccaratoAntonella PiscitelliRaffaele PiscitelliAlfredo ValenteGiulio CalellaNicola CoppolaGiustino Parruti<h4>Background & aims</h4>Hepatitis C (HCV) is associated with several extrahepatic manifestations, and estimates of the hospitalization burden related to these comorbidities are still limited. The aim of this study is to quantify the hospitalization risk associated with comorbidities in an Italian cohort of HCV-infected patients and to assess which of these comorbidities are associated with high hospitalization resource utilization.<h4>Methods</h4>Individuals aged 18 years and older with HCV-infection were identified in the Abruzzo's and Campania's hospital discharge abstracts during 2011-2014 with 1-year follow-up. Cardio-and cerebrovascular disease, diabetes and renal disease were grouped as HCV-related comorbidities. Negative binomial models were used to compare the hospitalization risk in patients with and without each comorbidity. Logistic regression model was used to identify the characteristics of being in the top 20% of patients with the highest hospitalization costs (high-cost patients).<h4>Results</h4>15,985 patients were included; 19.9% had a liver complication and 48.6% had one or more HCV-related comorbidities. During follow-up, 36.0% of patients underwent at least one hospitalization. Liver complications and the presence of two or more HCV-related comorbidities were the major predictors of hospitalization and highest inpatient costs. Among those, patients with cardiovascular disease had the highest risk of hospitalization (Incidence Rate Ratios = 1.42;95%CI:1.33-1.51) and the highest likelihood of becoming high-cost patients (Odd Ratio = 1.37;95%CI:1.20-1.57).<h4>Conclusion</h4>Beyond advanced liver disease, HCV-related comorbidities (especially cardiovascular disease) are the strongest predictors of high hospitalization rates and costs. Our findings highlight the potential benefit that early identification and treatment of HCV might have on the reduction of hospitalization costs driven by extrahepatic conditions.https://doi.org/10.1371/journal.pone.0219396 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Simona Cammarota Anna Citarella Antonella Guida Valeria Conti Teresa Iannaccone Maria Elena Flacco Francesca Bravi Cristina Naccarato Antonella Piscitelli Raffaele Piscitelli Alfredo Valente Giulio Calella Nicola Coppola Giustino Parruti |
spellingShingle |
Simona Cammarota Anna Citarella Antonella Guida Valeria Conti Teresa Iannaccone Maria Elena Flacco Francesca Bravi Cristina Naccarato Antonella Piscitelli Raffaele Piscitelli Alfredo Valente Giulio Calella Nicola Coppola Giustino Parruti The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). PLoS ONE |
author_facet |
Simona Cammarota Anna Citarella Antonella Guida Valeria Conti Teresa Iannaccone Maria Elena Flacco Francesca Bravi Cristina Naccarato Antonella Piscitelli Raffaele Piscitelli Alfredo Valente Giulio Calella Nicola Coppola Giustino Parruti |
author_sort |
Simona Cammarota |
title |
The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). |
title_short |
The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). |
title_full |
The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). |
title_fullStr |
The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). |
title_full_unstemmed |
The inpatient hospital burden of comorbidities in HCV-infected patients: A population-based study in two Italian regions with high HCV endemicity (The BaCH study). |
title_sort |
inpatient hospital burden of comorbidities in hcv-infected patients: a population-based study in two italian regions with high hcv endemicity (the bach study). |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2019-01-01 |
description |
<h4>Background & aims</h4>Hepatitis C (HCV) is associated with several extrahepatic manifestations, and estimates of the hospitalization burden related to these comorbidities are still limited. The aim of this study is to quantify the hospitalization risk associated with comorbidities in an Italian cohort of HCV-infected patients and to assess which of these comorbidities are associated with high hospitalization resource utilization.<h4>Methods</h4>Individuals aged 18 years and older with HCV-infection were identified in the Abruzzo's and Campania's hospital discharge abstracts during 2011-2014 with 1-year follow-up. Cardio-and cerebrovascular disease, diabetes and renal disease were grouped as HCV-related comorbidities. Negative binomial models were used to compare the hospitalization risk in patients with and without each comorbidity. Logistic regression model was used to identify the characteristics of being in the top 20% of patients with the highest hospitalization costs (high-cost patients).<h4>Results</h4>15,985 patients were included; 19.9% had a liver complication and 48.6% had one or more HCV-related comorbidities. During follow-up, 36.0% of patients underwent at least one hospitalization. Liver complications and the presence of two or more HCV-related comorbidities were the major predictors of hospitalization and highest inpatient costs. Among those, patients with cardiovascular disease had the highest risk of hospitalization (Incidence Rate Ratios = 1.42;95%CI:1.33-1.51) and the highest likelihood of becoming high-cost patients (Odd Ratio = 1.37;95%CI:1.20-1.57).<h4>Conclusion</h4>Beyond advanced liver disease, HCV-related comorbidities (especially cardiovascular disease) are the strongest predictors of high hospitalization rates and costs. Our findings highlight the potential benefit that early identification and treatment of HCV might have on the reduction of hospitalization costs driven by extrahepatic conditions. |
url |
https://doi.org/10.1371/journal.pone.0219396 |
work_keys_str_mv |
AT simonacammarota theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT annacitarella theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT antonellaguida theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT valeriaconti theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT teresaiannaccone theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT mariaelenaflacco theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT francescabravi theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT cristinanaccarato theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT antonellapiscitelli theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT raffaelepiscitelli theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT alfredovalente theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT giuliocalella theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT nicolacoppola theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT giustinoparruti theinpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT simonacammarota inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT annacitarella inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT antonellaguida inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT valeriaconti inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT teresaiannaccone inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT mariaelenaflacco inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT francescabravi inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT cristinanaccarato inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT antonellapiscitelli inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT raffaelepiscitelli inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT alfredovalente inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT giuliocalella inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT nicolacoppola inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy AT giustinoparruti inpatienthospitalburdenofcomorbiditiesinhcvinfectedpatientsapopulationbasedstudyintwoitalianregionswithhighhcvendemicitythebachstudy |
_version_ |
1714805869140508672 |