Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 10, Number 2, April 2017, pages 70-77

Changing Trends in Age, Gender, Racial Distribution and Inpatient Burden of Achalasia

Figure 4. Frequency of in-hospital deaths for hospitalizations with principal diagnosis of achalasia.

**Table 1.** Demographic Characteristics and Trends of Patients Hospitalized With Achalasia in 1997 and 2013
Factor	1997	2013	P-value
CCI: Charleston comorbidity index; SE: standard error. Data are presented as frequency (%) unless otherwise specified.
Total discharges, n	2,493	0.8	5,195	1.5
Age (years), mean ± SE	58.0 ± 1.4		57.2 ± 0.71		0.39
Age (years)					0.017
< 1	8 (0.33)	0.02	10 (0.19)	0.02
1 - 17	96 (3.9)	0.54	160 (3.1)	1.1
18 - 44	664 (26.6)	0.73	1,235 (23.8)	1.4
45 - 64	573 (23.0)	0.92	1,715 (33.0)	2
65 - 84	833 (33.4)	0.86	1,580 (30.4)	1.6
85+	319 (12.8)	1.4	495 (9.5)	1.7
Gender					0.59
Male	1,120 (44.9)	0.82	2,255 (43.4)	1.5
Female	1,373 (55.1)	0.7	2,940 (56.6)	1.4
Race					0.004
White	1,569 (78.6)	0.82	3,305 (68.2)	1.5
Black	221 (11.1)	0.61	830 (17.1)	1.7
Hispanic	142 (7.1)	0.59	435 (9.0)	1.07
Other	64 (3.2)	0.57	275 (5.7)	1.2
Primary payer					0.4
Medicare	1,146 (46.0)	0.95	2,270 (43.7)	1.6
Medicaid	201 (8.1)	0.37	460 (8.9)	0.62
Private insurance	979 (39.3)	0.76	1,970 (37.9)	1.8
Other	167 (6.7)	0.59	495 (9.5)	1.5
Median household income (quartile)					< 0.001
1	706 (29.8)	0.66	1,325 (25.9)	1.3
2	518 (21.9)	0.81	1,260 (24.6)	1.4
3	313 (13.2)	0.66	1,290 (25.2)	1.5
4	830 (35.1)	0.88	1,250 (24.4)	1.8
Therapeutic interventions
Esophageal dilation	547 (22.0)		710 (13.7)		< 0.001
Heller myotomy	1,458		3,755		< 0.001
Esophagectomy	41 (1.6)		110 (2.1)		0.49
CCI, mean ± SE	2.2 ± 0.13		2.5 ± 0.08		0.078
CCI
0 - 1	1,149 (46.1)	0.66	2,280 (43.9)	1.4
2 - 3	609 (24.4)	0.96	1,295 (24.9)	1.8
4 - 5	569 (22.8)	0.88	1,025 (19.7)	1.5
6 - 7	148 (5.9)	0.65	425 (8.2)	1.2
8+	19 (0.77)	0.22	170 (3.3)	0.95
Inflation-adjusted costs (2013 $)	9,290.2 ± 672.3		47,706.9 ± 2933.3		< 0.001
Hospital region					0.77
Northeast	607 (24.4)	0.89	1,160 (22.3)	1.7
Midwest	500 (20.0)	0.65	1,185 (22.8)	1.5
South	878 (35.2)	0.71	1,745 (33.6)	1.3
West	508 (20.4)	0.8	1,105 (21.3)	1.6
Hospital bed size					< 0.001
Small	302 (12.2)	0.57	470 (9.0)	0.96
Medium	860 (34.6)	0.78	955 (18.4)	1
Large	1,322 (53.2)	0.79	3,770 (72.6)	1.8
Hospital location					< 0.001
Non-metropolitan	339 (13.6)	0.66	275 (5.3)	0.7
Metropolitan	2,144 (86.4)	0.77	4,920 (94.7)	1.6
Hospital teaching status					< 0.001
Non-teaching hospital	1,216 (49.0)	0.58	1,390 (26.8)	0.81
Teaching hospital	1,267 (51.0)	1.04	3,805 (73.2)	2.1

Table 1. Demographic Characteristics and Trends of Patients Hospitalized With Achalasia in 1997 and 2013

Factor

1997

2013

P-value

Achalasia

Achalasia per 10,000 discharges

Achalasia

Achalasia per 10,000 discharges

CCI: Charleston comorbidity index; SE: standard error. Data are presented as frequency (%) unless otherwise specified.

Total discharges, n

2,493

0.8

5,195

1.5

Age (years), mean ± SE

58.0 ± 1.4

57.2 ± 0.71

0.39

Age (years)

0.017

< 1

8 (0.33)

0.02

10 (0.19)

0.02

1 - 17

96 (3.9)

0.54

160 (3.1)

1.1

18 - 44

664 (26.6)

0.73

1,235 (23.8)

1.4

45 - 64

573 (23.0)

0.92

1,715 (33.0)

65 - 84

833 (33.4)

0.86

1,580 (30.4)

1.6

85+

319 (12.8)

1.4

495 (9.5)

1.7

Gender

0.59

Male

1,120 (44.9)

0.82

2,255 (43.4)

1.5

Female

1,373 (55.1)

0.7

2,940 (56.6)

1.4

Race

0.004

White

1,569 (78.6)

0.82

3,305 (68.2)

1.5

Black

221 (11.1)

0.61

830 (17.1)

1.7

Hispanic

142 (7.1)

0.59

435 (9.0)

1.07

Other

64 (3.2)

0.57

275 (5.7)

1.2

Primary payer

0.4

Medicare

1,146 (46.0)

0.95

2,270 (43.7)

1.6

Medicaid

201 (8.1)

0.37

460 (8.9)

0.62

Private insurance

979 (39.3)

0.76

1,970 (37.9)

1.8

Other

167 (6.7)

0.59

495 (9.5)

1.5

Median household income (quartile)

< 0.001

706 (29.8)

0.66

1,325 (25.9)

1.3

518 (21.9)

0.81

1,260 (24.6)

1.4

313 (13.2)

0.66

1,290 (25.2)

1.5

830 (35.1)

0.88

1,250 (24.4)

1.8

Therapeutic interventions

Esophageal dilation

547 (22.0)

710 (13.7)

< 0.001

Heller myotomy

1,458

3,755

< 0.001

Esophagectomy

41 (1.6)

110 (2.1)

0.49

CCI, mean ± SE

2.2 ± 0.13

2.5 ± 0.08

0.078

CCI

0 - 1

1,149 (46.1)

0.66

2,280 (43.9)

1.4

2 - 3

609 (24.4)

0.96

1,295 (24.9)

1.8

4 - 5

569 (22.8)

0.88

1,025 (19.7)

1.5

6 - 7

148 (5.9)

0.65

425 (8.2)

1.2

19 (0.77)

0.22

170 (3.3)

0.95

Inflation-adjusted costs (2013 $)

9,290.2 ± 672.3

47,706.9 ± 2933.3

< 0.001

Hospital region

0.77

Northeast

607 (24.4)

0.89

1,160 (22.3)

1.7

Midwest

500 (20.0)

0.65

1,185 (22.8)

1.5

South

878 (35.2)

0.71

1,745 (33.6)

1.3

West

508 (20.4)

0.8

1,105 (21.3)

1.6

Hospital bed size

< 0.001

Small

302 (12.2)

0.57

470 (9.0)

0.96

Medium

860 (34.6)

0.78

955 (18.4)

Large

1,322 (53.2)

0.79

3,770 (72.6)

1.8

Hospital location

< 0.001

Non-metropolitan

339 (13.6)

0.66

275 (5.3)

0.7

Metropolitan

2,144 (86.4)

0.77

4,920 (94.7)

1.6

Hospital teaching status

< 0.001

Non-teaching hospital

1,216 (49.0)

0.58

1,390 (26.8)

0.81

Teaching hospital

1,267 (51.0)

1.04

3,805 (73.2)

2.1