Rising Cardiometabolic Comorbidity and Inpatient Resource Utilization Among Hospitalized Patients with Hepatocellular...

Area of Science:

• Hepatology
• Oncology
• Health Services Research

Background:

• Hospitalizations for hepatocellular carcinoma (HCC) are increasingly influenced by chronic liver disease, cardiometabolic conditions, and systemic complications.
• Contemporary data on the impact of comorbidities on inpatient resource use and procedural care for HCC are limited.

Purpose of the Study:

• To examine national trends in inpatient characteristics, procedural utilization, and outcomes for HCC hospitalizations from 2018 to 2022.
• To assess the influence of evolving comorbidity burden on resource utilization and care patterns.

Main Methods:

• Retrospective, cross-sectional analysis of adult hospitalizations using the National Inpatient Sample (NIS) from 2018-2022.
• Identification of HCC hospitalizations via ICD-10 codes; survey-weighted analyses for prevalence, mortality, length of stay, and charges.
• Multivariable logistic regression to identify predictors of inpatient mortality and procedural utilization (liver transplantation, hepatic resection, TIPS).

Main Results:

• An estimated 275,000 HCC hospitalizations occurred nationwide.
• Significant increase in cardiometabolic comorbidities (MASLD, obesity, diabetes, dyslipidemia) and rising in-hospital mortality (8.82% to 9.23%).
• Increased length of stay and hospitalization charges; stable, low rates of definitive interventions (transplantation, resection, TIPS), with mortality linked to hepatic decompensation and systemic illness.

Conclusions:

• Between 2018-2022, HCC inpatient resource utilization rose alongside increasing cardiometabolic comorbidity.
• Management of hepatic decompensation and systemic illness, not oncologic intervention, primarily drove increased resource use.
• Findings highlight the growing complexity of contemporary HCC hospitalizations.