3%) had a diagnosis of AKI. AKI diagnoses increased nearly 3-fold, from 5,922 in 2002 to 17,320 in 201 0, and the use of HD for AKI increased from 748 selleck inhibitor to 1,441. The mean age of patients receiving HD was 57, and 65.3% were male. 21.1% of patients received HD in non-liver transplant centers. The Elixhauser comorbidity index was similar for those receiving (3.7) versus those not receiving HD (3.5). 1 1.8% of those receiving HD had decompensated
cirrhosis. Private insurance was more common among those receiving HD (30.1 vs. 24.3%). Overall inpatient mortality for those on HD decreased over time, from 50.5% in 2002 to 3 1.7% in 201 0, and was higher in transplant centers (53.4 vs. 3 1.3%). Mortality for those with decompensated cirrhosis who received HD was 42.1%. After adjusting for disease severity and other patient-level factors, HD was associated with increased mortality (odds ratio 2.15; 95% confidence interval, 2.02–2.29). Hepatic decompensation, sepsis, self-pay insurance status and hepatocellular carcinoma were also independently associated with increased mortality. Private insurance, Medicare, Medicaid, and receipt of a liver or kidney transplant were associated with decreased mortality. Median length of stay was significantly longer for
those receiving HD (1 3 versus 7 days), and median total charges were significantly higher ($92,312 versus $37,277). Conclusion: AKI appears to be increasing amongst hospitalized cirrhotics while HD utilization is increasing at a lower rate. A significant number of patients receive HD at non-transplant centers. HD in this Daporinad cell line population is associated with substantial mortality, costs, and length of stay. More detailed information on these patients and longer-term outcomes are needed to assess the growing use of HD and its cost-effectiveness. Disclosures: Monica Schmidt – Grant/Research Support: Merck & Co.; Patent Held/Filed: HCCplex; Stock Shareholder: PleX Diagnostics Alfred see more S. Barritt – Grant/Research Support: Salix Pharmaceuticals; Speaking and Teaching: Abbott Molecular The following people have nothing to disclose:
Paul H. Hayashi, Eric S. Orman Background: In patients with HCV, evidence of cirrhosis should trigger several therapeutic and preventive measures. One such example is hepatocellular cancer (HCC) screening. However, success of any screening program is contingent upon early identification of all at-risk patients—i.e., those with cirrhosis. The extent to which cirrhosis is under-diagnosed in HCV and the subsequent impact on HCC stage in clinical practice is unclear. Methods: We identified HCV patients from the national VA HCV Clinical Case Registry between 1995 and 2010. We determined the prevalence of cirrhosis on the basis of (a) validated ICD9 codes for cirrhosis & (b) >1 AST to platelet ratio index (APRI) score > 2.0. We calculated the incidence rate of HCC in patients with cirrhosis classified based on ICD9 codes or APRI.