PMID- 37664693
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230928
IS  - 2327-2236 (Electronic)
IS  - 2326-697X (Print)
IS  - 2326-697X (Linking)
VI  - 5
IP  - 1
DP  - 2017
TI  - One-year Prevalence, Comorbidities, and Cost of Hospitalizations for Alpha-1 
      Antitrypsin Deficiency among Patients with Chronic Obstructive Pulmonary Disease 
      in the United States.
PG  - 65-74
LID - 10.36469/9799 [doi]
AB  - Objectives: Little is known about severe chronic obstructive pulmonary disease 
      (COPD) exacerbations among patients with Alpha-1 Antitrypsin Deficiency (AATD). 
      We assessed inpatients with AATD and COPD among a sample of COPD inpatients to 
      ascertain demographic, clinical and economic differences in the course of disease 
      and treatment. Methods: Using data from the 2009 Nationwide Inpatient Sample 
      (NIS), we identified COPD (ICD-9-CM: 491.xx, 492.xx, or 496.xx) patients with 
      AATD (273.4). We compared patient demographics and healthcare outcomes (eg, 
      length of stay, inpatient death, type and number of procedures, and cost of care) 
      between COPD patients with and without alpha-1 antitrypsin deficiency. 
      Frequencies and percentages for patient demographics were compared using 
      bivariate statistics (eg, chi-square test). Recognizing the non-parametric nature 
      of length of stay and cost, we calculated median values and interquartile ranges 
      for these variables for each group of patients. Finally, the risk of inpatient 
      death was estimated using logistic regression. Results: Of 840 242 patients with 
      COPD (10.8% of the NIS sample population), 0.08% (684) had a primary or secondary 
      diagnosis code for AATD. COPD+AATD were younger (56 vs 70, p<0.0001) and as a 
      result, less likely to be covered by Medicare (44% vs 62%, p<0.0001). AATD 
      patients were also more likely to have comorbid non-alcoholic liver disease (7% 
      vs 2%, p<0.0001), depression (17% vs 13%, p=0.0328), and pulmonary circulation 
      disorders (7% vs 4%, p=0.0299). Patients with AATD had a 14% longer length of 
      stay (IRR = 1.14, 95% CI 1.07, 1.21) and a mean cost of $1487 (p=0.0251) more 
      than COPD inpatients without AATD. Conclusions: AATD is associated with increased 
      mean length of stay and cost, as well as higher frequency of comorbid 
      non-alcoholic liver disease, depression, and pulmonary circulation disorders. 
      Future research should assess other differences between AATD and the general COPD 
      population such as natural history of disease, treatment responsiveness and 
      disease progression.
FAU - Blanchette, Christopher M
AU  - Blanchette CM
AD  - University of North Carolina, Charlotte NC, USA.
FAU - Zacherle, Emily
AU  - Zacherle E
AD  - University of North Carolina, Charlotte NC, USA.
FAU - Noone, Joshua M
AU  - Noone JM
AD  - University of North Carolina, Charlotte NC, USA.
FAU - Van Doren, Bryce A
AU  - Van Doren BA
AD  - University of North Carolina, Charlotte NC, USA.
FAU - Roy, Debosree
AU  - Roy D
AD  - University of North Carolina, Charlotte NC, USA.
FAU - Howden, Reuben
AU  - Howden R
AD  - University of North Carolina, Charlotte NC, USA.
LA  - eng
PT  - Journal Article
DEP - 20170721
PL  - United States
TA  - J Health Econ Outcomes Res
JT  - Journal of health economics and outcomes research
JID - 101648581
PMC - PMC10471378
OTO - NOTNLM
OT  - aatd
OT  - alpha-1 antitrypsin deficiency
OT  - chronic obstructive pulmonary disease
OT  - copd
OT  - hospitalization
EDAT- 2017/07/21 00:00
MHDA- 2017/07/21 00:01
PMCR- 2017/07/21
CRDT- 2023/09/04 05:17
PHST- 2017/07/21 00:01 [medline]
PHST- 2017/07/21 00:00 [pubmed]
PHST- 2023/09/04 05:17 [entrez]
PHST- 2017/07/21 00:00 [pmc-release]
AID - 9799 [pii]
AID - 10.36469/9799 [doi]
PST - epublish
SO  - J Health Econ Outcomes Res. 2017 Jul 21;5(1):65-74. doi: 10.36469/9799. 
      eCollection 2017.