Abstract Number: PB1198
Meeting: ISTH 2021 Congress
Background: HIV infection is considered a prothrombotic condition associated with a 2- to 10-fold increase in VTE in HIV-infected patients compared to general population.
Aims: We aim to compare outcomes of patients admitted with acute VTE with HIV (VTE-HIV) and without HIV (VTE-no-HIV).
Methods: US Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) was queried to identify HIV and non-HIV acute VTE admissions between 2016-2018. We studied socio-demographic differences, medical comorbidities, healthcare utilization, all-cause mortality and secondary outcomes listed in Table-1. Statistics were performed using t-test and univariate and multinomial logistic regression.
Results: We identified 3050 VTE-HIV and 866,745 VTE-no-HIV admissions. VTE-HIV patients were significantly younger (mean age 51.6 vs 62.8 years), male (73% vs 48%), African American (AA) (59% vs 19%), admitted to teaching hospitals (81% vs 67%), on Medicaid (34% vs 12%), all p<0.001. Rates of CKD, hemodialysis, liver disease and protein energy malnutrition were significantly higher in HIV-VTE while dyslipidemia, hypertension, obesity and smoking were significantly higher in VTE-no-HIV, all p<0.05. VTE-HIV group had lower adjusted inpatient mortality (aOR 0.25, CI:0.13-0.48, p<0.001) while mean length of stay (LOS) (5.6 vs 4.4 days, p<0.01) and mean total hospital charges (THC) (54,961 vs 47,007, p<0.01) were higher than VTE-no-HIV. Rates of thrombolysis, thrombectomy, cardiac arrest were similar while VTE-HIV was associated with lower rates of ICU admissions (p<0.05). Table-1.
|Outcome||Without HIV||With HIV||aOR (95% CI)||p-value|
|In-hospital mortality||2.3%||1.6%||0.25 (0.13-0.48)||0.00*|
Length of Stay
|4.4 (4.3 – 4.4)||5.6 (4.7 – 6.5)||-1.2 (-1.6 to -0.9)#||0.00*|
|Total hospital charges
(46,350 – 47,665)
(48,136 – 61,786)
(-13307 to -2601)#
|tPA administration||4.8%||3%||1.1 (0.65 – 1.8)||0.7|
|Thrombectomy||2.9%||2.8%||1.3 (0.76 – 2.3)||0.3|
|Intracranial Hemorrhage||0.25%||0.16%||0.08 (0.01 – 0.58)||0.01*|
|Cardiac Arrest||1.1%||0.66%||0.51 (0.18 – 0.14)||0.19|
|ICU admission||2.4%||2.1%||0.52 (0.29 – 0.9)||0.026*|
|Abbreviations: *=statistically significant, #=unadjusted mean difference, aOR=adjusted odds ratio, CI=confidence interval, tPA=tissue plasminogen activator, ICU=Intensive Care Unit.
Adjusting factors: age, race, gender, hospital location and teaching status, hospital bed size and region, insurance, dyslipidemia, coronary artery disease, hypertension, diabetes mellitus, obesity, heart failure, chronic kidney disease, smoking, liver disease, hemodialysis, protein-energy malnutrition.
Conclusions: VTE-HIV patients are younger, AA, men with significantly lower mortality and ICU-admissions compared to HIV-no-VTE but higher LOS and THC amounting to over $24 million in 3 years. While higher prevalence of CKD and hemodialysis may partly explain the increased THC in HIV-VTE patients, these discrepancies between outcome and healthcare utilization need to be studied further to save costs.
To cite this abstract in AMA style:Tariq MJ, Almani MU, Tufail J, Elsebaie MA, Baral B, Usman M, Gupta S. Acute VTE in HIV versus Non-HIV population – Nationwide Analysis of Mortality, Morbidity, Demographics and Healthcare Utilization [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/acute-vte-in-hiv-versus-non-hiv-population-nationwide-analysis-of-mortality-morbidity-demographics-and-healthcare-utilization/. Accessed November 29, 2021.
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