To examine trends in morbidity, hospital length and cost of stay in narcolepsy patients with low and high comorbidity index.

METHODS: The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with narcolepsy. Propensity score matched analysis was conducted to compare mortality hospital, LOS and costs in patients with low and high comorbidity index. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

RESULTS:

In 2016, there were an estimated 17,935 hospitalizations with a diagnosis of narcolepsy. Approximately 52% and 48% had comorbidity index of <3 and ≥ 3, respectively. The mean age was 51.6 (SD 18.6) and 63.9 (SD 14.5) in low and high comorbidity groups, respectively. 63.5% and 57.5% were female in low and high comorbidity groups, respectively. Most common comorbidities (more than 10%) were congestive heart failure (18.3%), cardiac arrhythmias (20.9%), hypertension (44.7%), chronic pulmonary disease (34.9%), diabetes (17.3% uncomplicated, 15.2% complicated), renal failure (15.9%) and depression (30.6%). The propensity score matched hospital LOS was 3.5 and 5.9 days, with a statistically significant difference of 2.4 days (SE 0.31, P<0.05), in low and high comorbidity groups, respectively. The propensity score matched hospital charges were $39,684 and $58,915, with a statistically significant difference of $19,230 (SE $4036, P<0.05), in low and high comorbidity groups, respectively.

CONCLUSIONS: Narcolepsy patients with high comorbidity index incur significantly longer hospital length of stay and nearly 50% more costs compared to patients with low comorbidity index. There is a need for better treatment management for narcolepsy patients with high comorbidity index.