Trends of autoimmune liver disease inpatient hospitalization and mortality from 2011 to 2017: A United States nationwide analysis

Table 1 Weighted hospital admissions with autoimmune liver diseases diagnosis years 2011-2017, mean ± SD

	2011	2012	2013	2014	2015	2016	2017	P value	P value
Primary AiLD diagnosis	13432	12650	12960	12595	12040	10505	10100		< 0.0001
Total AiLD admissions	83263	81430	84080	90350	88515	72585	74850
Total admissions	36962415	36484846	35597792	35358818	35769942	35675421	35798453
Total AiLD admission rate (%)	0.23	0.22	0.24	0.26	0.25	0.20	0.21
Age group (%)
< 25	2.47	2.62	2.65	2.68	2.37	2.81	2.55	0.65	< 0.0001
25-44	11.7	11.53	11.98	12.53	12.12	13.52	12.73	< 0.0001
45-64	32.53	31.9	31.3	30.28	30.31	33.18	32.22	0.96
65/65+	53.3	53.95	54.07	54.5	55.21	50.49	52.5	0.0008
Reported death (%)	4.67	4.23	4.6	4.39	4.9	5.56	5.43	< 0.0001	< 0.0001
Type of insurance/payment (%)									< 0.0001
Medicare	56.3	57.5	57.1	57.73	57.75	54.81	56.47	0.15
Medicaid	9.21	9.04	9.08	10.21	10.44	11.81	11.32	< 0.0001
Private insurance	28.25	26.98	27.03	27.1	27.06	28.66	27.3	0.97
Self-Pay	3.35	3.61	3.69	2.62	2.51	2.31	2.43	< 0.0001
No charge	0.59	0.39	0.56	0.26	0.19	0.22	0.27	< 0.0001
Other	2.3	2.48	2.54	2.08	2.05	2.19	2.2	0.01
Median household income based on zip code (%)									< 0.0001
0-25th percentile	25.08	25.43	24.48	24.74	25.97	25.76	25.22	0.03
26th to 50th percentile (median)	24.85	24.48	25.22	27.06	24.32	24.79	25.67	0.1
51st to 75th percentile	26.61	24.88	26.44	23.72	25.18	25.28	24.7	0.001
76th to 100th percentile	23.47	25.21	23.86	24.48	24.53	24.17	24.41	0.48
Sex (%)									0.0079
Male	39.92	41.08	40.86	40.97	41.17	40.34	39.44	0.25
Female	60.08	58.92	59.14	59.03	58.83	59.66	60.56	0.25
Hospital bedsize (%)									< 0.0001
Small	10.19	11.76	11.7	15.72	14.57	14.69	15.54	< 0.0001
Medium	22.22	24.11	23.85	26.05	26.48	25.37	25.16	< 0.0001
Large	67.59	64.12	64.45	58.23	58.95	59.94	59.3	< 0.0001
Hospital region									0.0006
Northeast	21.29	22.1	21.5	21.17	20.82	20.16	20.62	0.0007
Midwest	22.65	22.79	22.52	22.93	23.53	23.58	23.2	0.17
South	33.9	32.42	33.31	32.82	33.16	34.04	34.2	0.26
West	22.16	22.69	22.67	23.08	22.49	22.22	21.98	0.49
Race (%)									< 0.0001
White	69.39	69.82	68.82	69.7	69.04	68.22	67.54	0.35
Black	10.43	9.84	10.58	10.44	10.9	11.63	11.87	< 0.0001
Hispanic	13.15	11.67	12.2	11.52	11.59	11.91	12.51	0.56
Asian or Pacific Islander	3.7	4.24	4.67	4.66	4.66	4.14	4.07	0.03
Native American	0.6	0.72	0.67	0.67	0.74	0.86	0.77	0.006
Other	2.72	3.72	3.06	3.01	3.07	3.24	3.24	0.17
Hospital location (%)									< 0.0001
Rural	8.55	7.91	7.44	5.95	5.68	5.85	5.35	< 0.0001
Urban nonteaching	35.08	31.78	31.58	20.82	21.41	19.12	17.11	< 0.0001
Urban teaching	56.38	60.31	60.98	73.23	72.91	75.03	77.54	< 0.0001
Discharge (%)									< 0.0001
Routine	58.53	59.21	57.87	57.56	57.08	56.17	55.37	< 0.0001
Transfer to short-term hospital	4.86	4.64	4.82	4.62	4.67	4.8	4.51	0.54
Transfer other1	15.52	15.69	15.43	16.19	15.63	14.89	15.2	0.15
Home health care	15.88	15.76	16.76	16.65	17.19	17.97	18.67	< 0.0001
Against medical advice	0.47	0.42	0.49	0.53	0.53	0.58	0.79	< 0.0001
Died	4.67	4.23	4.6	4.39	4.9	5.56	5.43	< 0.0001
Total charges	66031 ± 959.67	64643 ± 917.22	67530± 873.54	70390 ± 846.90	73081 ± 935.86	75856 ± 1162.0	78987 ± 1120.29	< 0.0001	< 0.0001
Length of stay	6.94 ± 0.07	6.72 ± 0.07	6.65 ± 0.06	6.76 ± 0.06	6.70 ± 0.06	6.56 ± 0.06	6.51 ± 0.06	< 0.0001	< 0.0001

¹Includes skilled nursing facility, intermediate care facility, another type of facility.

AiLD: Autoimmune liver diseases.

Table 2 Weighted mortality-related risk factors among deceased hospitalized patients diagnosed with autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis, 2011-2017

	2011	2012	2013	2014	2015	2016	2017	P value
n	83263	81430	84080	90350	88515	72585	74850
Risk factors
Sepsis (%)	13.08	11.17	10.65	10.49	26.65	71.94	73.93	< 0.0001
Gastrointestinal hemorrhage (%)	10.94	9.17	9.24	10.24	10.14	12.71	11.81	0.07
Acute renal failure (%)	61.94	63.1	65.47	67.54	68.34	68.71	68.82	< 0.0001

Table 3 Weighted hospital admissions resulting in mortality with autoimmune liver diseases diagnosis years 2011-2017, mean ± SD

	2011	2012	2013	2014	2015
Total mean charges ($)	66031 ± 959.67	64643 ± 917.22	67530 ± 873.54	70390 ± 846.90	73081 ± 935.86
Age group
< 25	66380	58196	70023	64827	70241
25-44	67980	59435	64813	63039	77106
45-64	71465	70030	70951	72934	78617
65/65+	62294	62889	66035	70965	69282
Type of insurance/payment
Medicare	63976	62771	65338	69634	69826
Medicaid	89300	74468	78293	73732	85970
Private insurance	63474	66434	69955	70758	74432
Self-Pay	59502	58456	62497	67545	76839
No charge	42195	46303	71761	55820	56524
Other	67153	64584	60546	75497	77006
Sex
Male	73209	72125	74568	77969	80807
Female	61244	59435	62677	65143	67712
Race
White	61321	60626	62750	66755	67207
Black	81958	66471	74005	73835	85676
Hispanic	84390	78300	87317	84775	86062
Asian or Pacific Islander	105588	110862	89349	102233	103801
Native American	57071	50091	60905	55484	62996
Other	71681	74580	86077	85352	97951
Linear regression was used to assess trend in charges over years within each demographic group

¹Two-Sided Cochran-Armitage Trend Tests were performed for all categorical variables to test trend. Simple Linear Regression was performed for all continuous variables to test trend.