Excess Medical Costs of Malignant Hyperthermia in the United States, 2017 - 2021

Rohan Bhardwaj 1, BA; Matthew Russell2, BS; Henry Rosenberg2, MD; Teeda Pinyavat2, MD; Jean Guglielminotti2, MD, PhD; Guohua Li2, MD, DrPH

INTRODUCTION

-Malignant hyperthermia (MH) is a rare but severe pharmacogenetic disorder triggered by inhaled general anesthetics and succinylcholine in people with certain mutations in the RYR1 gene.

-Despite proper treatment with dantrolene, the mortality rate from MH is thought to be between 3% and 5%. (Watt et al., 2023)

METHODS

Data source: HCUP National Inpatient Sample (NIS) 2017-2021 (represents approx. 20% of all hospital admissions in the US)

Case Identification: Patients with MH diagnosis (n = 320): identified through ICD-10-CM code (T88.3)

Matching criteria: Patients without MH diagnosis (n = 1196): for each MH patient, up to five patients without MH diagnosis are randomly selected from the same year and the same hospital as the MH patient. Patients without MH diagnosis and the patient with MH diagnosis are matched on age (± 2 years), sex, admission mode, DRG, and principal procedure.

Outcomes: Primary outcome is total hospital cost based on total hospital charges from admission to discharge corrected by the cost-to-charge ratios; Secondary outcome is length of stay (LOS) measured in days between admission to discharge

MAIN RESULTS: Total Hospital costs 

-Estimated annual number of inpatients with MH diagnosis in U.S: 315

-Average excess hospital costs per inpatient with MH diagnosis: $32,821

-Total annual hospital costs attributed to MH in U.S.: $10,338,615

-Patients with MH diagnosis