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Toxin, drug-induced hepatitis increasing in south, western US

Hospital discharges for toxin and drug-induced hepatitis increased significantly between 2001 and 2011 in the U.S., particularly in the south and the west, while rates decreased in the northeast, according to a presentation at the World Congress of Gastroenterology at ACG 2017.

Khwaja F. Haq, MD
Khwaja F. Haq

According to the researchers, toxin and drug-induced hepatitis (TDIH) is the leading cause of acute hepatitis failure in developed countries, though it is difficult to study because the broad array of culprit agents, the wide range of clinical presentations, and the lack of diagnostic tests.

“We know, over the past decade, multiple drugs have been recognized as agents of toxin and drug-induced hepatitis and have been restricted or removed from the market. Trends of our analysis may reflect some of these important safety measures,” Khwaja F. Haq, MD, from New York Medical College at Westchester Medical Center, said in an author insight on the ACG blog. “Additionally, significant demographic variations, increasing trend in cost of care, and decreasing trend in mortality was noted during the study period.”

To assess the burden of TDIH in the U.S., the researchers conducted a retrospective study using the National Inpatient Sample (NIS) database.

Hospital discharges for TDIH increased from 39,503 in 2001 to 46,789 in 2011 (P < .0001). Discharge rates for TDIH increased significantly among patients aged 50 years to 64 years, whereas rates decreased significantly among those aged 35 years to 49 years (P < .0001).

Women and Caucasians accounted for the highest number of discharges for TDIH (P < .0001). Comparatively, the researchers observed a downward trend among those discharged from rural hospitals, those with higher median household incomes, and patients with private health insurance (P < .0001).

Patients in the south accounted for the highest percentage of TDIH discharges (approximately 41%). TDIH discharge rates increased in the west from 17.6% to 20.2% during the study, whereas rates decreased from 18.2% to 15.6% in the northeast (P < .0001).

In-hospital mortality decreased during the study from 5.4% to 5% (P < .0001); however, the mean cost of care increased from $14,366 to $15,727, adjusted for inflation (P < .0001). – by Talitha Bennett

Reference:

Haq KF, et al. Abstract 53. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.

Disclosure: One researcher reports serving on the speakers bureau for AbbVie, Gilead, Intercept, Merck and Salix.

Hospital discharges for toxin and drug-induced hepatitis increased significantly between 2001 and 2011 in the U.S., particularly in the south and the west, while rates decreased in the northeast, according to a presentation at the World Congress of Gastroenterology at ACG 2017.

Khwaja F. Haq, MD
Khwaja F. Haq

According to the researchers, toxin and drug-induced hepatitis (TDIH) is the leading cause of acute hepatitis failure in developed countries, though it is difficult to study because the broad array of culprit agents, the wide range of clinical presentations, and the lack of diagnostic tests.

“We know, over the past decade, multiple drugs have been recognized as agents of toxin and drug-induced hepatitis and have been restricted or removed from the market. Trends of our analysis may reflect some of these important safety measures,” Khwaja F. Haq, MD, from New York Medical College at Westchester Medical Center, said in an author insight on the ACG blog. “Additionally, significant demographic variations, increasing trend in cost of care, and decreasing trend in mortality was noted during the study period.”

To assess the burden of TDIH in the U.S., the researchers conducted a retrospective study using the National Inpatient Sample (NIS) database.

Hospital discharges for TDIH increased from 39,503 in 2001 to 46,789 in 2011 (P < .0001). Discharge rates for TDIH increased significantly among patients aged 50 years to 64 years, whereas rates decreased significantly among those aged 35 years to 49 years (P < .0001).

Women and Caucasians accounted for the highest number of discharges for TDIH (P < .0001). Comparatively, the researchers observed a downward trend among those discharged from rural hospitals, those with higher median household incomes, and patients with private health insurance (P < .0001).

Patients in the south accounted for the highest percentage of TDIH discharges (approximately 41%). TDIH discharge rates increased in the west from 17.6% to 20.2% during the study, whereas rates decreased from 18.2% to 15.6% in the northeast (P < .0001).

In-hospital mortality decreased during the study from 5.4% to 5% (P < .0001); however, the mean cost of care increased from $14,366 to $15,727, adjusted for inflation (P < .0001). – by Talitha Bennett

Reference:

Haq KF, et al. Abstract 53. Presented at: World Congress of Gastroenterology at American College of Gastroenterology Annual Scientific Meeting; Oct. 13-18, 2017; Orlando, FL.

Disclosure: One researcher reports serving on the speakers bureau for AbbVie, Gilead, Intercept, Merck and Salix.

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