Abstract：
UNASSIGNED: This study aimed to assess and compare the health care resource utilization (HCRU) and medical cost of metabolic dysfunction-associated steatohepatitis (MASH) by disease severity based on Fibrosis-4 Index (FIB-4) score among US adults in a real-world setting.
UNASSIGNED: This observational cohort study used claims data from the Healthcare Integrated Research Database (HIRD) to compare all-cause, cardiovascular (CV)-related, and liver-related HCRU, including hospitalization, and medical costs stratified by FIB-4 score among patients with MASH (identified by International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] code K75.81). Hospitalization and medical costs were compared by FIB-4 score using generalized linear regression with negative binomial and gamma distribution models, respectively, while controlling for confounders.
UNASSIGNED: The cohort included a total of 5,104 patients with MASH and comprised 3,162, 1,343, and 599 patients with low, indeterminate, and high FIB-4 scores, respectively. All-cause hospitalization was significantly higher in the high FIB-4 cohort when compared with the low FIB-4 reference after covariate adjustment (rate ratio, 1.63; 95% CI, 1.32-2.02; p < .0001). CV-related hospitalization was similar across all cohorts; however, CV-related costs were 1.26 times higher (95% CI, 1.11-1.45; p < .001) in the indeterminate cohort and 2.15 times higher (95% CI, 1.77-2.62; p < .0001) in the high FIB-4 cohort when compared with the low FIB-4 cohort. Patients with indeterminate and high FIB-4 scores had 2.97 (95% CI, 1.78-4.95) and 12.08 (95% CI, 7.35-19.88) times the rate of liver-related hospitalization and were 3.68 (95% CI, 3.11-4.34) and 33.73 (95% CI, 27.39-41.55) times more likely to incur liver-related costs, respectively (p < .0001 for all).
UNASSIGNED: This claims-based analysis relied on diagnostic coding accuracy, which may not capture the presence of all diseases or all care received.
UNASSIGNED: High and indeterminate FIB-4 scores were associated with significantly higher liver-related clinical and economic burdens than low FIB-4 scores among patients with MASH.
MASH is a serious liver disease that can lead to fibrosis, cirrhosis, and other complications. There is a need to understand the impact of disease severity on the burden of MASH. Health care claims data were used to assess the use of medical resources, including hospitalization, and medical costs among patients with 3 different levels of severity of MASH, as assessed via FIB-4 score. FIB-4 is a widely available non-invasive marker of severity. Rates of all-cause, cardiovascular-related and liver-related hospitalization and medical costs were several-fold higher in patients with high disease severity of MASH than those with low disease severity of MASH.
UNASSIGNED: This observational cohort study used claims data from the Healthcare Integrated Research Database (HIRD) to compare all-cause, cardiovascular (CV)-related, and liver-related HCRU, including hospitalization, and medical costs stratified by FIB-4 score among patients with MASH (identified by International Classification of Diseases, Tenth Revision, Clinical Modification [ICD-10-CM] code K75.81). Hospitalization and medical costs were compared by FIB-4 score using generalized linear regression with negative binomial and gamma distribution models, respectively, while controlling for confounders.
UNASSIGNED: The cohort included a total of 5,104 patients with MASH and comprised 3,162, 1,343, and 599 patients with low, indeterminate, and high FIB-4 scores, respectively. All-cause hospitalization was significantly higher in the high FIB-4 cohort when compared with the low FIB-4 reference after covariate adjustment (rate ratio, 1.63; 95% CI, 1.32-2.02; p < .0001). CV-related hospitalization was similar across all cohorts; however, CV-related costs were 1.26 times higher (95% CI, 1.11-1.45; p < .001) in the indeterminate cohort and 2.15 times higher (95% CI, 1.77-2.62; p < .0001) in the high FIB-4 cohort when compared with the low FIB-4 cohort. Patients with indeterminate and high FIB-4 scores had 2.97 (95% CI, 1.78-4.95) and 12.08 (95% CI, 7.35-19.88) times the rate of liver-related hospitalization and were 3.68 (95% CI, 3.11-4.34) and 33.73 (95% CI, 27.39-41.55) times more likely to incur liver-related costs, respectively (p < .0001 for all).
UNASSIGNED: This claims-based analysis relied on diagnostic coding accuracy, which may not capture the presence of all diseases or all care received.
UNASSIGNED: High and indeterminate FIB-4 scores were associated with significantly higher liver-related clinical and economic burdens than low FIB-4 scores among patients with MASH.
MASH is a serious liver disease that can lead to fibrosis, cirrhosis, and other complications. There is a need to understand the impact of disease severity on the burden of MASH. Health care claims data were used to assess the use of medical resources, including hospitalization, and medical costs among patients with 3 different levels of severity of MASH, as assessed via FIB-4 score. FIB-4 is a widely available non-invasive marker of severity. Rates of all-cause, cardiovascular-related and liver-related hospitalization and medical costs were several-fold higher in patients with high disease severity of MASH than those with low disease severity of MASH.
摘要：
■本研究旨在根据纤维化-4指数（FIB-4）评分，根据疾病严重程度评估和比较代谢功能障碍相关脂肪性肝炎（MASH）的医疗保健资源利用（HCRU）和医疗成本在现实世界中的美国成年人中。
■这项观察性队列研究使用了来自医疗保健综合研究数据库（HIRD）的索赔数据来比较所有原因，心血管（CV）相关，和肝脏相关的HCRU，包括住院,和医疗费用按MASH患者的FIB-4评分分层(由国际疾病分类确定，第十次修订,临床改装[ICD-10-CM]代码K75.81)。住院和医疗费用通过FIB-4评分使用广义线性回归与负二项和伽马分布模型进行比较，分别,同时控制混杂因素。
■该队列共包括5,104名MASH患者，包括3,162、1,343和599名患者，不确定，FIB-4的高分,分别。在协变量调整后，与低FIB-4参考相比，高FIB-4队列中的全因住院率明显更高（率比，1.63；95%CI，1.32-2.02；P<0.0001）。所有队列中与CV相关的住院情况相似；然而，与低FIB-4队列相比，不确定队列的CV相关费用高1.26倍（95％CI，1.11-1.45；P<.001），高FIB-4队列高2.15倍（95％CI，1.77-2.62；P<.0001）。FIB-4评分不确定且较高的患者的肝脏相关住院率分别为2.97（95％CI，1.78-4.95）和12.08（95％CI，7.35-19.88）倍，分别为3.68（95％CI，3.11-4.34）和33.73（95％CI，27.39-41.55）倍，分别为（所有P<0.0001）。
■这种基于索赔的分析依赖于诊断编码的准确性，可能无法捕获所有疾病的存在或所接受的所有护理。
■在MASH患者中，高和不确定的FIB-4评分与肝脏相关的临床和经济负担明显高于低FIB-4评分。
MASH是一种严重的肝脏疾病，可导致纤维化，肝硬化,和其他并发症。有必要了解疾病严重程度对MASH负担的影响。医疗保健索赔数据被用来评估医疗资源的使用情况，包括住院,3种不同程度的MASH患者的医疗费用，通过FIB-4评分评估。FIB-4是广泛可用的严重程度的非侵入性标志物。所有原因的比率，MASH疾病严重程度高的患者的心血管相关和肝脏相关的住院和医疗费用比MASH疾病严重程度低的患者高几倍.
■这项观察性队列研究使用了来自医疗保健综合研究数据库（HIRD）的索赔数据来比较所有原因，心血管（CV）相关，和肝脏相关的HCRU，包括住院,和医疗费用按MASH患者的FIB-4评分分层(由国际疾病分类确定，第十次修订,临床改装[ICD-10-CM]代码K75.81)。住院和医疗费用通过FIB-4评分使用广义线性回归与负二项和伽马分布模型进行比较，分别,同时控制混杂因素。
■该队列共包括5,104名MASH患者，包括3,162、1,343和599名患者，不确定，FIB-4的高分,分别。在协变量调整后，与低FIB-4参考相比，高FIB-4队列中的全因住院率明显更高（率比，1.63；95%CI，1.32-2.02；P<0.0001）。所有队列中与CV相关的住院情况相似；然而，与低FIB-4队列相比，不确定队列的CV相关费用高1.26倍（95％CI，1.11-1.45；P<.001），高FIB-4队列高2.15倍（95％CI，1.77-2.62；P<.0001）。FIB-4评分不确定且较高的患者的肝脏相关住院率分别为2.97（95％CI，1.78-4.95）和12.08（95％CI，7.35-19.88）倍，分别为3.68（95％CI，3.11-4.34）和33.73（95％CI，27.39-41.55）倍，分别为（所有P<0.0001）。
■这种基于索赔的分析依赖于诊断编码的准确性，可能无法捕获所有疾病的存在或所接受的所有护理。
■在MASH患者中，高和不确定的FIB-4评分与肝脏相关的临床和经济负担明显高于低FIB-4评分。
MASH是一种严重的肝脏疾病，可导致纤维化，肝硬化,和其他并发症。有必要了解疾病严重程度对MASH负担的影响。医疗保健索赔数据被用来评估医疗资源的使用情况，包括住院,3种不同程度的MASH患者的医疗费用，通过FIB-4评分评估。FIB-4是广泛可用的严重程度的非侵入性标志物。所有原因的比率，MASH疾病严重程度高的患者的心血管相关和肝脏相关的住院和医疗费用比MASH疾病严重程度低的患者高几倍.
