Table 2.
Outcomes and prior healthcare among patients with and without “late” diagnosis of HCV*
| With late diagnosis* n=1056 (17%) |
Without late diagnosis n=5117 (83%) |
Incidence Risk Ratio (95% Confidence Interval) | p-value** | ||
|---|---|---|---|---|---|
| Years of observation after initial HCV dx | Mean (median) | 5.7 (5.0) | 4.7 (3.7) | p<.001 | |
| Hospitalization | |||||
| Hospitalized at least once after initial HCV diagnosis | n (%) | 619 (58%) | 1,799 (35.2%) | p<.001 | |
| Total hospitalizations after HCV diagnosis | n/100 person-years (p-y) | 64.1 | 19.7 | 3.2 (3.1–3.4) | p<.001 |
| Total hospital days after HCV diagnosis | n/100 p-y | 403.1 | 102.9 | 3.9 (3.9–4.0) | p<.001 |
| Deaths during the six-year period 2006–11 | n (%) | 346 (32.8%) | 480 (9.4%) | p<.001 | |
| n/100 p-y | 6.7 | 1.8 | 3.8 (3.2–4.2) | p<.001 | |
| Years from HCV diagnosis to death | mean (median) | 3.4 (2.2) | 5.8 (5.5) | p<.001 | |
| Prior healthcare | |||||
| Years in health system prior to HCV diagnosis | mean (median) | 5.7 (5.0) | 4.7 (3.7) | p< 0.001 | |
| Any inpatient or outpatient healthcare system visit more than one year prior to HCV diagnosis | n (%) | 953 (90%) | 4,428 (87%) | p < 0.001 | |
| Ever emergency room visit in this period | n (%) | 494(47%) | 1,565 (31%) | p < 0.001 | |
| Number of emergency room visits | mean (median) | 4.6 (2) | 3.2 (2) | p< 0.001 | |
| Ever hospitalized in this period | n (%) | 256 (24%) | 783 (15%) | p< 0.001 | |
| Number of hospitalizations | mean (median) | 2.4 (1) | 1.7 (1) | p< 0.001 | |
| ALT ever elevated in this period | n (%) | 194 (18%) | 496 (10%) | p < 0.001 | |
| Years from first ALT elevation to HCV dx | mean (median) | 4.1 (3.2) | 3.8 (3.0) | p < 0.001 | |
Late diagnosis defined as having either a biopsy indicating fibrosis or a FIB-4 score >5.88 8,9 during the time period from three months prior up to twelve months post initial HCV diagnosis, or: during the time period from prior to up to twelve months post initial HCV diagnosis having an ICD9 diagnosis or procedure code indicating liver transplant (996.82, 50.5, 50.51, 50.59, 47135, 47136), hepatocellular carcinoma (155.0 155.1 155.2), liver failure (572.4), hepatic encephalopathy (572.2), portal hypertension (572.3, 37140, 37160, 37180, 37181, 37182, 37183), esophageal varices (456.0, 456.20, 43204, 43205, 43243, 43244, 43400, 43401, 42.91, 44.91, 96.06), other gastroesophageal hemorrhage (530.7, 530.82, 578.0, 578.1, 578.9), ascites (789.5, 789.59, 49080, 49081, 54.91), or other sequelae of chronic liver disease (572.8).
For comparison of rates of hospitalization and death per person-year incidence ratios were calculated with 95% confidence intervals and p-value with Chi-Square test. SAS procedure FREQ was applied for comparisons of percentages and procedure TTEST was used to compare means and p-values.