Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States

Introduction. Hepatic encephalopathy (HE), a complication of cirrhosis, is associated with increased healthcare resource utilization and mortality, and impaired quality of life. Information on the prevalence of HE in the US general population is limited. Methods. Prevalence of HE was estimated by se...

Full description

Saved in:
Bibliographic Details
Main Authors: Aniruddha Potnis, Susan VanMeter, Jan Stange
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Hepatology
Online Access:http://dx.doi.org/10.1155/2021/8542179
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832561350495174656
author Aniruddha Potnis
Susan VanMeter
Jan Stange
author_facet Aniruddha Potnis
Susan VanMeter
Jan Stange
author_sort Aniruddha Potnis
collection DOAJ
description Introduction. Hepatic encephalopathy (HE), a complication of cirrhosis, is associated with increased healthcare resource utilization and mortality, and impaired quality of life. Information on the prevalence of HE in the US general population is limited. Methods. Prevalence of HE was estimated by sequential stepwise data analysis of the Symphony Health anonymized patient-level data (APLD) claims database. First, patients≥18 years with International Classification of Diseases ninth/tenth edition, clinical modification (ICD-9/10-CM), and codes for cirrhosis from 2018 medical and hospital claims were used to estimate prevalence of cirrhosis within the data set and number of patients with cirrhosis in the US general population. Second, patients diagnosed with cirrhosis in the APLD data set from 2015–2016 with an HE ICD-9/10-CM code within 1 year of cirrhosis diagnosis were used to deduce the prevalence of HE within the data set and estimate the number of patients with HE in the US general population. Last, US DiagnosticSource data on serum ammonia level laboratory results measured within ±2 days of a confirmed HE event were merged with the APLD HE data set, then applied to the US general population. Results. Medical and hospital claims data were available for 272,256 patients with cirrhosis in 2018. An estimated 536,856 US adults had a diagnosis of cirrhosis (prevalence of 0.21%) in 2018. This proportion applied to the estimated number of patients with cirrhosis in the United States resulted in a prevalence estimate of 201,858 cirrhosis patients with HE in 2018. When factoring in serum ammonia data, prevalence was conservatively estimated as approximately 196,000 cirrhosis patients with HE and serum ammonia levels>21 μmol/L. Conclusions. In this longitudinal cohort–based study, it was estimated that ≈202,000 patients had HE in the United States in 2018, representing a considerable burden to society and payers.
format Article
id doaj-art-3e3837521ff24743a5665088eff1dfdf
institution Kabale University
issn 2090-3448
2090-3456
language English
publishDate 2021-01-01
publisher Wiley
record_format Article
series International Journal of Hepatology
spelling doaj-art-3e3837521ff24743a5665088eff1dfdf2025-02-03T01:25:18ZengWileyInternational Journal of Hepatology2090-34482090-34562021-01-01202110.1155/2021/85421798542179Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United StatesAniruddha Potnis0Susan VanMeter1Jan Stange2Mallinckrodt Pharmaceuticals, Hampton, NJ, USAMallinckrodt Pharmaceuticals, Hampton, NJ, USAMallinckrodt Pharmaceuticals, Hampton, NJ, USAIntroduction. Hepatic encephalopathy (HE), a complication of cirrhosis, is associated with increased healthcare resource utilization and mortality, and impaired quality of life. Information on the prevalence of HE in the US general population is limited. Methods. Prevalence of HE was estimated by sequential stepwise data analysis of the Symphony Health anonymized patient-level data (APLD) claims database. First, patients≥18 years with International Classification of Diseases ninth/tenth edition, clinical modification (ICD-9/10-CM), and codes for cirrhosis from 2018 medical and hospital claims were used to estimate prevalence of cirrhosis within the data set and number of patients with cirrhosis in the US general population. Second, patients diagnosed with cirrhosis in the APLD data set from 2015–2016 with an HE ICD-9/10-CM code within 1 year of cirrhosis diagnosis were used to deduce the prevalence of HE within the data set and estimate the number of patients with HE in the US general population. Last, US DiagnosticSource data on serum ammonia level laboratory results measured within ±2 days of a confirmed HE event were merged with the APLD HE data set, then applied to the US general population. Results. Medical and hospital claims data were available for 272,256 patients with cirrhosis in 2018. An estimated 536,856 US adults had a diagnosis of cirrhosis (prevalence of 0.21%) in 2018. This proportion applied to the estimated number of patients with cirrhosis in the United States resulted in a prevalence estimate of 201,858 cirrhosis patients with HE in 2018. When factoring in serum ammonia data, prevalence was conservatively estimated as approximately 196,000 cirrhosis patients with HE and serum ammonia levels>21 μmol/L. Conclusions. In this longitudinal cohort–based study, it was estimated that ≈202,000 patients had HE in the United States in 2018, representing a considerable burden to society and payers.http://dx.doi.org/10.1155/2021/8542179
spellingShingle Aniruddha Potnis
Susan VanMeter
Jan Stange
Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
International Journal of Hepatology
title Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
title_full Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
title_fullStr Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
title_full_unstemmed Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
title_short Prevalence of Hepatic Encephalopathy from a Commercial Medical Claims Database in the United States
title_sort prevalence of hepatic encephalopathy from a commercial medical claims database in the united states
url http://dx.doi.org/10.1155/2021/8542179
work_keys_str_mv AT aniruddhapotnis prevalenceofhepaticencephalopathyfromacommercialmedicalclaimsdatabaseintheunitedstates
AT susanvanmeter prevalenceofhepaticencephalopathyfromacommercialmedicalclaimsdatabaseintheunitedstates
AT janstange prevalenceofhepaticencephalopathyfromacommercialmedicalclaimsdatabaseintheunitedstates