The National Inpatient Sample was utilized to identify all adult (≥ 18 years old)
NAFLD hospitalizations with PUD in the United States from 2009-2019. Hospitalization trends and outcomes were highlighted. Furthermore, a control group of adult PUD hospitalizations without
NAFLD was also identified for a comparative analysis to assess the influence of
NAFLD on PUD.
RESULTS: The total number of
NAFLD hospitalizations with PUD increased from 3745 in 2009 to 3805 in 2019. We noted an increase in the mean age for the study population from 56 years in 2009 to 63 years in 2019 (P < 0.001). Racial differences were also prevalent as
NAFLD hospitalizations with PUD increased for Whites and Hispanics, while a decline was observed for Blacks and Asians. The all-cause inpatient mortality for
NAFLD hospitalizations with PUD increased from 2% in 2009 to 5% in 2019 (P < 0.001). However, rates of Helicobacter pylori (H. pylori)
infection and upper endoscopy decreased from 5% in 2009 to 1% in 2019 (P < 0.001) and from 60% in 2009 to 19% in 2019 (P < 0.001), respectively. Interestingly, despite a significantly higher comorbidity burden, we observed lower inpatient mortality (2% vs 3%, P = 0.0004), mean
length of stay (LOS) (11.6 vs 12.1 d, P < 0.001), and mean total healthcare cost (
THC) ($178598 vs $184727, P < 0.001) for
NAFLD hospitalizations with PUD compared to non-
NAFLD PUD hospitalizations. Perforation of the gastrointestinal tract, coagulopathy,
alcohol abuse,
malnutrition, and fluid and
electrolyte disorders were identified to be independent predictors of inpatient mortality for
NAFLD hospitalizations with PUD.
CONCLUSION: Inpatient mortality for
NAFLD hospitalizations with PUD increased for the study period. However, there was a significant decline in the rates of H. pylori
infection and upper endoscopy for
NAFLD hospitalizations with PUD. After a comparative analysis,
NAFLD hospitalizations with PUD had lower inpatient mortality, mean LOS, and mean
THC compared to the non-
NAFLD cohort.