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S1406 Trend of Hospitalized Patients With a Diagnosis of NAFLD Across a 4-Year Period From 2016-2019

American Journal of Gastroenterology(2022)

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Abstract
Introduction: The prevalence of Non-alcoholic fatty liver disease (NAFLD) has been increasing in the US and Non-alcoholic Steatohepatitis is the most rapidly increasing indication for a liver transplant. We evaluated the burden, contemporary trends, baseline characteristics, and overall mortality of hospitalized patients with NAFLD in the US using the National Inpatient Sample (NIS) database. Methods: The 2016-2019 NIS database was used to identify all adults (age >18) with NAFLD using the relevant ICD 10 codes K76.0, K75.81. Baseline characteristics including gender, racial distribution, and mortality during hospitalization among these patients were obtained from the information available within the database. We used Stata 17.0 SE-Standard Edition (StataCorp, 4905 Lakeway Drive, College Station, TX). The data was tabulated to appreciate the trend. Results: NAFLD patients accounted for 1-1.5% of all hospitalizations in the US (Table). We identified 373,135 hospitalized patients with NAFLD in 2016, which steadily increased to 532,485 patients in 2019. The majority of the patients were females (55 % vs. 45%; p < 0.01) across all years. We also found that NAFLD was more commonly associated with whites with a prevalence of ∼70% across all years. The overall mortality rate of patients hospitalized with NAFLD across all years was 1.8%. Conclusion: In this study, we found that there is a steady increase in the number of patients hospitalized with NAFLD from 2016 to 2019 in the US. This is similar to the increasing trend that was reported in a 2007-2014 study. White females were the most common group of patients that we found in the database. The mortality rate has remained stable at 1.8% from 2016 to 2019. Evidence supports that the primary pathophysiological derangement in most patients with NAFLD is insulin resistance and that weight loss helps in reversing the liver inflammation. Even though there have been recent advances in the treatment of obesity and diabetes which are strongly associated with NAFLD, we did not notice any major difference in the prevalence of patients hospitalized with a diagnosis of NAFLD. The reasons could include that these treatment modalities may not be available to all patients or there may be a lack of awareness of these to the general population. More studies are needed to support our findings. Table 1. - Results 2016 2017 2018 2019 Total NAFLD 373, 135 (1 %) 417504 (1.1%) 476215 (1.3%) 532485 (1.5%) Males 167389 (45%) 187469 (45%) 216290 (45%) 242730 (45%) Females 205384 (55%) 230014 (55%) 259904 (54%) 289715 (54%) White 70% 69% 68% 68% Black 9.3% 9.3% 9.3% 9.3% Hispanic 15% 15% 15% 16% Other 3% 3% 3% 3.1% NAFLD died 6904.997 (1.8%) 7699.999 (1.8%) 8545.0079 (1.8%) 9854.998 (1.8%)
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Key words
nafld,hospitalized patients,diagnosis
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