Spontaneous Bacterial Peritonitis Inpatient Admissions: Trends and Disparities of Outcomes from 2010-2019 in the US

Abstract

Aim: Our study sought to evaluate racial and economic disparities trends and outcomes during hospitalizations for SBP in the last decade.

Material and Methods: This retrospective cohort study used the National Inpatient Sample (NIS) to identify adult patients with a principal admitting diagnosis of SBP from 2010-2019. The primary outcomes evaluated in this study were racial and sociodemographic differences in outcomes of SBP hospitalizations [inpatient mortality rate, mean length of hospital stay (LOS), and mean total hospital charges (THC)]

Results: There were 69785 hospitalizations with a principal admitting diagnosis for SBP. Jointpoint analysis showed that between 2010-2013, an annual percentage increase was observed [7.8%, 95% C.I (-2.9, 19.6), p = 0.124], while between 2013-2019, an annual percentage decrease was found [-2.7%, 95% C.I (-0.5, -0.2), p = 0.037]. Over the decade, there was a 13.5% decrease in the prevalence of middle-aged patients hospitalized for SBP (p <0.001). Also, a 4.8% decrease in the In-patient mortality rate (p <0.001) and a 1.1-day reduction in the mean length of stay (p <0.001) were noted. Patients admitted with SBP were more likely to have higher proportions of middle-aged males and white people with Medicare insurance and were likely to be treated at large bed sizes and in urban teaching hospitals.

Conclusions: Over the 10-year trend, the incidence of SBP hospitalizations peaked in 2013, followed by a sharp decline in hospitalizations from 2013-2019. While the overall mortality rate and length of stay have decreased, the THC has surprisingly remained unchanged.