Disparities in Outcomes of Hospitalizations Due to Multiple Myeloma: A Nationwide Comparison
Sushmita Khadka1, Swetha Balaji2, Japjeet Kaur3
1Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA.
Abstract:
Background With the advent of novel treatments, there is a declining trend in the multiple myeloma (MM) mortality rate with an increasing hospitalization rate. However, there is limited population-based data on trends and outcomes of hospitalizations due to MM in the United States (US). Methods We analyzed the publicly available Nationwide Inpatient Sample (NIS) from 2007 to 2017 to identify MM hospitalizations. Results Hospitalizations for MM increased from 17,100 (8.71%) in 2007 to 19,490 (9.92%) in 2017. The in-hospital mortality rate declined from 8.4% in 2007 to 4.9% in 2017 (P <0.001) and discharge to facilities decreased from 20.4% in 2007 to 17.4% in 2017 (P <0.001). The odds of in-hospital mortality were higher with increasing age (odds ratio (OR): 1.46; 95% confidence interval (CI): 1.38 -1.54; P <0.0001), pneumonia (OR: 4.18; 95% CI: 3.63 - 4.81, P <0.0001), septicemia (OR: 2.50; 95% CI: 2.22 - 2.82; P <0.0001), renal failure (OR: 1.48; 95% CI: 1.34 -1.64; P <0.0001), uninsured/self-pay insurance status (OR: 2.69; 95% CI: 2.18 - 3.3; P <0.0001), rural hospital (OR: 2.26; 95% CI: 1.88 -2.72; P<0.0001), and urban-non-teaching hospitals (OR: 1.38; 95% CI: 1.23 - 1.56; P <0.0001). Also, increasing age (OR: 1.14; 95% CI: 1.11-1.18, P <0.0001), Black race (OR: 1.12; 95% CI: 1.02-1.23, P <0.0001), and multiple comorbidities were associated with higher disability. Conclusion Hospitalizations for MM continued to increase, whereas in-hospital mortality continued to decrease. Advanced age, sepsis, pneumonia, and renal failure were associated with higher odds of mortality in MM patients.
Insights
Hospitalizations for multiple myeloma (MM) rose from 2007 to 2017, but in-hospital deaths significantly decreased. Key factors increasing mortality risk include advanced age, pneumonia, and renal failure.
Area of Science:
- Hematology
- Epidemiology
- Health Services Research
Background:
- Novel treatments have led to a decline in multiple myeloma (MM) mortality rates.
- Despite improved outcomes, MM hospitalizations are increasing, necessitating population-based data analysis.
- Limited data exists on US hospitalization trends and outcomes for MM patients.
Purpose of the Study:
- To analyze trends and outcomes of hospitalizations for multiple myeloma (MM) in the United States.
- To identify factors associated with in-hospital mortality and disability in MM patients.
Main Methods:
- Analysis of the Nationwide Inpatient Sample (NIS) database from 2007 to 2017.
- Identification of MM hospitalizations and assessment of in-hospital mortality rates.
- Statistical analysis to determine factors associated with mortality and disability.
Main Results:
- MM hospitalizations increased from 17,100 (8.71%) in 2007 to 19,490 (9.92%) in 2017.
- In-hospital mortality rate decreased from 8.4% in 2007 to 4.9% in 2017.
- Higher mortality odds were linked to older age, pneumonia, septicemia, renal failure, uninsured status, and rural hospitals. Increased age, Black race, and comorbidities were associated with higher disability.
Conclusions:
- Multiple myeloma hospitalizations are increasing, while in-hospital mortality is decreasing.
- Advanced age, pneumonia, septicemia, and renal failure are significant risk factors for mortality in hospitalized MM patients.
- Understanding these trends and risk factors is crucial for improving patient care and outcomes.
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