Hospitalization at the end of life in patients with multiple myeloma
Saqib Abbasi1, John Roller1, Al-Ola Abdallah1
1Department of Hematological Malignancies and Cellular Therapeutics, Kansas University Medical Center, Kansas City, USA.
Background:
Despite advances in treatment, multiple myeloma (MM) remains incurable and results in significant morbidity and mortality. Further research investigating where MM patients die and characterization of end-of-life hospitalizations is needed.
Methods:
We utilized the National Inpatient Sample (NIS) to explore the hospitalization burden of MM patients at the end of their lives.
Results:
The percent of patients dying in the hospital as a percent of overall MM deaths ranged from 54% in 2002 to 41.4% in 2017 (p < 0.01). Blood transfusions were received in 32.7% of these hospitalizations and infections were present in 47.8% of patients. Palliative care and/or hospice consultations ranged from 5.3% in 2002 to 31.4% in 2017 (p < 0.01).
Conclusion:
Our study demonstrates that patients with MM dying in the hospital have a significant requirement for blood transfusions and have a high infection burden. We also show that palliative care and hospice involvement at the end of life has increased over time but remains low, and that ultimately, inpatient mortality has decreased over time, but MM patients die in the hospital at a higher rate than the general population.
Insights
Multiple myeloma (MM) patients increasingly receive palliative care but still have high rates of blood transfusions and infections at end-of-life hospitalizations. Inpatient mortality for MM patients has decreased but remains higher than the general population.
Area of Science:
- Oncology
- Hematology
- Palliative Care
Background:
- Multiple myeloma (MM) is an incurable blood cancer with significant patient morbidity and mortality.
- Understanding end-of-life care patterns for MM patients is crucial for improving outcomes.
Purpose of the Study:
- To investigate the hospitalization burden of MM patients at the end of their lives.
- To characterize end-of-life hospitalizations, including interventions and mortality trends.
Main Methods:
- Utilized the National Inpatient Sample (NIS) database.
- Analyzed hospitalization data for MM patients from 2002 to 2017.
Main Results:
- Inpatient mortality for MM patients decreased from 54% in 2002 to 41.4% in 2017.
- Blood transfusions were common (32.7%), as were infections (47.8%).
- Palliative care/hospice consultations increased significantly from 5.3% to 31.4% but remain low.
Conclusions:
- MM patients dying in hospitals require substantial blood transfusions and face a high burden of infection.
- While palliative and hospice care involvement has grown, it remains underutilized.
- Despite decreasing inpatient mortality, MM patients are still more likely to die in the hospital than the general population.
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