LAUSR

Patients with narcolepsy are at risk for adverse health consequences, which may make them more vulnerable to hospital admissions. Moreover, narcolepsy can complicate the management of patients with other primary illnesses. There is scarce information about the characteristics of adult patients with narcolepsy who are admitted to hospital. The objective of the study was to describe a nationwide trend of patient characteristics and healthcare utilization of hospitalized adult patients with a comorbid narcolepsy. We analyzed the National Inpatient Sample over 20-year period between 2002 and 2021. Adults (> 18 years) with diagnosis of narcolepsy were identified based on the ICD 9th/10th revisions. High-risk mortality was defined as the All-Patient Refined Diagnosis-Related Group (APR-DRG) Risk of Mortality (“rating of 3-4 subclasses). Total charges were the main measurement of health care utilizations and were adjusted by applying for the Consumer Price Index (CPI) rate since 2012. Overall trend of 5-year period (year 2002-2006, 2007-2011, 2012-2016, 2017-2021) over 20-year period was calculated by ANOVA. A total of 49,610 hospital admissions were identified over 20-year period. Mean age was 57.6 (17.5) years old and female patients consisted of 61%. The most common race/ethnic group was White (71%) followed by Others (15%), and Black (10%). Hispanics (2.8%) and Asians (0.5%) were underrepresented. Over the period of 20-year period, there was a trend of increasing number of hospitalized patients with comorbid narcolepsy (n=9215, 11807, 11071, 14679, p< 0.0001). Mean age decreased over time (58.8 years, 57.7, 57.6, 56.8, p< 0.0001). The proportion of female (58.1%, 60.2, 61.7, 62.1, p< 0.0001) and White race (57.7%, 65.3, 76.2, 79.7, p< 0.0001) patients with narcolepsy increased over time whereas Other race decreased over time (32.3%, 22.6, 9.2, 5.0, p< 0.0001). The proportion of high-risk mortality patients with narcolepsy fluctuated but generally increased (22.2%, 30.7, 22.8, 33.9). Mean total charges showed uptrends from ($20,583, 30469, 40905, 53318, p< 0.0001). There is a trend of decreasing age, more female representation and a higher complexity of patients with narcolepsy admitted to US hospital over the past two decades. There appears to be underrepresentation of Hispanics and Asian races, implying underdiagnosis of narcolepsy.