One-year prevalence, comorbidities and cost of cachexia-related inpatient admissions in the USA

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Abstract

Background: Cachexia is a condition characterized as a loss in body mass or metabolic dysfunction and is associated with several prevalent chronic health conditions including many cancers, COPD, HIV, and kidney disease, with between 10 and 50% of patients with these conditions having cachexia. Currently there is little research into cachexia and our objective is to characterize cachexia patients, their healthcare utilisation, and associated hospitalization costs. Given the increasing prevalence of chronic diseases, it is important to better understand cachexia so that the condition can be better diagnosed and managed.

MethodsWe utilized one year (2009) of the Nationwide Inpatient Sample (NIS). The NIS represents all inpatient stays at a random 20% sample of all hospitals within the United States. We grouped cachexia individuals by primary or secondary discharge diagnosis and then compared those with cachexia to all others in terms of length of stay (LOS) and total cost. Finally we looked into factors predicting increased LOS using a negative binomial model.

Results: We estimated US prevalence for cachexia-related inpatient admissions at 161,898 cases. Cachexia patients were older, with an average age of 67.95 versus 48.10 years in their non-cachexia peers. Hospitalizations associated with cachexia had an increased LOS compared to non-cachexia patients (6 versus 3 days), with average costs per stay $4641.30 greater. Differences were seen in loss of function (LOF) with cachexia patients, mostly in the major LOF category (52.60%), whereas non-cachexia patients were spread between minor, moderate, and major LOF (36.28%, 36.11%, and 21.26%, respectively). Significant positive predictors of increased LOS among cachexia patients included urban hospital (IRR=1.21, non-teaching urban; IRR=1.23, teaching urban), having either major (IRR=1.41) or extreme (IRR=2.64) LOF, and having a primary diagnosis of pneumonia (IRR=1.15).

Conclusion: We have characterized cachexia and seen it associated with increased length of stay, increased cost, and more severe loss of function in patients compared to those without cachexia.

Keywords: muscle loss, cachexia, occurrence, outcomes research, patient costs, cancer cachexia, cardiac cachexia, chronic obstructive pulmonary disease

Citation: Arthur ST, Noone JM, Van Doren BA, Roy D, Blanchette CM. One-year prevalence, comorbidities and cost of cachexia-related inpatient admissions in the USA. Drugs in Context; 3: 212265. doi: 10.7573/dic.212265

Provenance: Submitted, externally peer reviewed

Dates: Submitted: 8 July 2014
; Accepted, subject to peer review: 10 July 2014
; Peer review comments to author: 14 July 2014; Revised manuscript submitted: 22 July 2014
; Published: 31 July 2014

Copyright: © 2014 Arthur ST, Noone JM, Van Doren BA, Roy D, Blanchette CM. Distributed under the terms of the Creative Commons Attribution License Deed CC BY 3.0. which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No other uses without permission.

Correct attribution: Copyright © 2014 Arthur ST, Noone JM, Van Doren BA, Roy D, Blanchette CM. http://dx.doi.org/10.7573/dic.212265. Published by Drugs in Context under Creative Commons Attribution License Deed CC BY 3.0.

Correspondence: Dr Susan Tsivitse Arthur, Laboratory of Systems Physiology, Department of Kinesiology, UNC Charlotte, 9201 University City Blvd., Charlotte, NC 28223, USA.

Email: sarthur8@uncc.edu

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