OBJECTIVES: To determine the characteristics, in-hospital mortality, and healthcare utilization of hospitalized adult patients with hepatic encephalopathy (HE) in the US.

METHODS: We used 2010 to 2015 national readmission data (NRD) from Healthcare Cost and Utilization Project (HCUP) to estimate the national prevalence, clinical characteristics, mortality, healthcare utilization and medical care cost of inpatient HE.

RESULTS: We identified 316,197 discharges with HE diagnosis (primary and secondary) from 2010 to 2015, representing 0.33% of all hospitalizations in the US. The in-hospital mortality increased from 8.47 to 9.0 during the study period with some fluctuations between years (P < .0001). However, we found patients have had increased comorbid conditions. The Elixhauser mortality index and the number of diagnoses has increased significantly (11.68 to 12.21, P <.05; 12.82 to 16.37, P < .05). The average number of procedures increased from 1.45 to 1.69 (P <.05) and the average length of stay increased from 6.19 to 6.90 (P <.05). Accordingly, the total inpatient charges increased from $43,284 to $62,068 with a corresponding increase of national total charges from $1,818.6 million to $4,100.9 million (P < .05). The independent predictors of inpatient mortality include primary diagnosis of HE (odds ratio [OR] = 2.336; 95% confidence interval [CI], 2.156-2.530), Elixhauzer mortality index (OR = 1.052; 95% CI, 1.048-1.055), number of diagnoses, per discharge (OR = 1.083; 95% CI, 1.077-1.090), number of procedures, per discharge (OR = 1.209; 95% CI, 1.198-1.221). The significant independent contributors to total charge, total cost, and length of stay are primary diagnosis of HE, the number of procedures and diagnoses per discharge, Elixhauser mortality score, and private insurance coverage (P < .001).

CONCLUSIONS: Health care resource utilization and inpatient mortality increased from 2010 to 2015 for hospitalized patients discharged with an HE diagnosis in the US.