Title

United States National Trends In Mortality, Length Of Stay (Los) And Associated Costs Of Cognitive Impairment In Hiv Population From 2005 To 2014

Keywords

Co-morbidity; HIV associated neurological disorders (HAND); ICD-9 codes; Morbidity; Mortality; Nationwide Inpatient Sample database (NIS)

Abstract

We evaluated national trends of in-hospital discharge rates, mortality outcomes, health care costs, length of stay in HIV patients with cognitive disorders. Neurological involvement in HIV is commonly associated with cognitive impairment termed as HIV-associated neurocognitive disorder (HAND) which includes a spectrum of neurocognitive dysfunction associated with HIV infection. Although severe and progressive neurocognitive impairment has become rare in HIV patients in the era of potent antiretroviral therapy, a majority of HIV patients have mild to moderate degree of neurocognitive impairment. Study population for this analysis was derived from the Nationwide Inpatient Sample from 2005 to 2014. Patients with ICD-9 code of HIV (042) with discharge diagnosis (Dx) listed top 1 through 5 were included in the analysis. Within this population, we identified patients with cognitive impairment using ICD-9 codes of 294 (persistent mental disorders; organic psychotic brain syndromes (chronic), 323.9 (encephalitis, myelitis, and encephalomyelitis), 331.83 (mild cognitive impairment) with Dx listed from 1 to 25. Patient variables obtained included: age, race, gender, length of stay, in-hospital mortality and insurance status. Hospital level variables included teaching status, location and region of country. SAS 9.4 software was used for data analysis. Comparisons of variables between hospitalized HIV patients with and without HAND showed significant increase in cost per hospital admissions, longer hospital stay and higher risk of mortality in patients with HAND.

Publication Date

10-1-2018

Publication Title

AIDS and Behavior

Volume

22

Issue

10

Number of Pages

3198-3208

Document Type

Article

Personal Identifier

scopus

DOI Link

https://doi.org/10.1007/s10461-018-2128-z

Socpus ID

85046016811 (Scopus)

Source API URL

https://api.elsevier.com/content/abstract/scopus_id/85046016811

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