摘要
Background and aims.Cholangiocarcinoma is a rare but devastating malignancy associated with a poor prognosis and a high mortality rate.With the recent advances in detection and treatment,it is unclear if the incidence and outcomes of cholangiocarcinoma are improving in the United States.The aim of this study was to evaluate the trends in the incidence,costs and mortality rates of cholangiocarcinoma-related hospital admissions in the USA.Methods.We utilized the National Inpatient Sample Database(NIS)from 1997–2012 for all patients in whom cholangiocarcinoma(ICD-9 code 155.1,156)was the principal discharge diagnosis.The temporal trends in the number of hospital admissions,length of stay and,hospitalization costs along with mortality rates over the study period were determined by using regression analysis for trends.Results.There was a significant increase in the number of hospital admissions for cholangiocarcinoma as the principal diagnosis from 1997 to 2012(10357 vs 11970,P<0.001).The mean length of stay for cholangiocarcinoma decreased by 17%between 1997 and 2012 from 9.5 days to 7.9 days(P<0.001).However,during the same period,the mean hospital charges per patient(adjusted for inflation)increased 113.25% from $36460 in 1997 to$77753 in 2012.The in-hospital mortality rate decreased from 9.3% in 1997 to 6.4% in 2012(P<0.001).Conclusions.There was a significant increase in the number of hospital admissions and associated costs from cholangiocarcinoma in the USA between 1997 and 2012.However,this was accompanied by a decrease in the inpatient mortality rates from cholangiocarcinoma.
背景:胆管癌是一种罕见但致命的恶性肿瘤,预后差,病死率高。随着近年来胆管癌诊治水平的提高,胆管癌在美国的发病率和治疗效果是否得到了改善尚不清楚。本研究的目的是以美国住院患者为对象,评估胆管癌发病率、治疗费用及住院病死率的变化趋势。方法:收集美国住院样本数据库(NIS)1997-2012年间第一出院诊断为胆管癌(ICD-9代码:155.1和156)的患者。采用趋势回归分析评估研究期间住院人数、住院时间、住院费用以及住院病死率的时间趋势。结果:研究期间,胆管癌作为主要诊断的住院人数显著增加,从1997年的10,357增加至2012年的11,970(P<0.001)。胆管癌患者的平均住院时间缩短了17%,从1997年的9.5天缩短至2012年的7.9天(P<0.001)。然而,在此期间,每例患者的平均住院费用(按通货膨胀进行调整后)增高了113.25%,由1997年的36,460美元提高至77,753美元。住院病死率由1997年的9.3%下降至2012年的6.4%(P<0.001)。结论:1997-2012年间,美国胆管癌住院人数和人均住院费用显著增加,而住院病死率则明显下降。
