Shantanu Solanki1, Raja Chandra Chakinala1, Khwaja Fahad Haq2, Muhammad Ali Khan3, Alina Kifayat4, Katherine Linder5, Zubair Khan6, Uvesh Mansuri7, Khwaja Saad Haq8, Christopher Nabors4, Wilbert S Aronow9. 1. Hospitalist Department, Guthrie Robert Packer Hospital, Sayre, PA, USA. 2. Division of Gastroenterology, Henry Ford Hospital, Detroit, MI, USA. 3. Division of Gastroenterology, University of Tennessee Health Science Center, Memphis, TN, USA. 4. Department of Medicine, New York Medical College at Westchester Medical Center, Valhalla, NY, USA. 5. Division of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA. 6. Department of Medicine, University of Toledo Medical Center, Toledo, OH, USA. 7. Department of Medicine, MedStar Health, Baltimore, MD, USA. 8. Department of Medicine, Kingsbrook Jewish Medical Center, Brooklyn, NY, USA. 9. Department of Cardiology, New York Medical College at Westchester Medical Center, Valhalla, NY, USA.
Abstract
BACKGROUND: Gastric cancer is associated with significant morbidity and mortality. Over one-half of patients have advanced disease at the time of presentation, leading to a significant burden on the healthcare system. Limited epidemiological data exists on national inpatient hospitalization trends. The aim of this study is to determine the inpatient burden of gastric cancer in the United States. METHODS: We analyzed the Nationwide Inpatient Sample (NIS) database for all subjects with the diagnosis of malignant neoplasm of the stomach (ICD-9 code 151.x) as primary diagnosis during the period from 2001-2011. NIS is the largest all-payer inpatient care database in the U.S. Statistical significance of variation in the number of hospitalizations, patient demographics, and comorbidity measures was determined using Cochran-Armitage trend test. RESULTS: From 2001 to 2011, the number of hospitalizations with the diagnosis of malignant neoplasm of the stomach ranged between 22,430 and 25,371, however, the trend was not significant. Men were always more affected than women with no significant change in overall proportion (P<0.0001). Overall, in-hospital mortality decreased from 11.19% in 2001 to 6.47% in 2011 (P<0.0001). However, average cost of care per hospitalization increased from $21,710 in 2001 to $24,706 in 2011 (adjusted for inflation, P<0.0001). CONCLUSIONS: The total number of hospitalizations remained relatively stable throughout the study period with higher proportion of men affected every year. Although in-hospital mortality in patients with the diagnosis of gastric cancer decreased over the study period, there was a significant rise in the cost of care. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Gastric cancer is associated with significant morbidity and mortality. Over one-half of patients have advanced disease at the time of presentation, leading to a significant burden on the healthcare system. Limited epidemiological data exists on national inpatient hospitalization trends. The aim of this study is to determine the inpatient burden of gastric cancer in the United States. METHODS: We analyzed the Nationwide Inpatient Sample (NIS) database for all subjects with the diagnosis of malignant neoplasm of the stomach (ICD-9 code 151.x) as primary diagnosis during the period from 2001-2011. NIS is the largest all-payer inpatient care database in the U.S. Statistical significance of variation in the number of hospitalizations, patient demographics, and comorbidity measures was determined using Cochran-Armitage trend test. RESULTS: From 2001 to 2011, the number of hospitalizations with the diagnosis of malignant neoplasm of the stomach ranged between 22,430 and 25,371, however, the trend was not significant. Men were always more affected than women with no significant change in overall proportion (P<0.0001). Overall, in-hospital mortality decreased from 11.19% in 2001 to 6.47% in 2011 (P<0.0001). However, average cost of care per hospitalization increased from $21,710 in 2001 to $24,706 in 2011 (adjusted for inflation, P<0.0001). CONCLUSIONS: The total number of hospitalizations remained relatively stable throughout the study period with higher proportion of men affected every year. Although in-hospital mortality in patients with the diagnosis of gastric cancer decreased over the study period, there was a significant rise in the cost of care. 2019 Annals of Translational Medicine. All rights reserved.
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