Hospital volume and acute myeloid leukemia mortality in Medicare beneficiaries aged 65 years and older

Thompson, Michael P.; Waters, Teresa M.; Kaplan, Erin K.; McKillop, Caitlin N.; Martin, Mike G.

doi:10.1182/blood-2016-05-716662

Cited by 13 publications

(9 citation statements)

References 21 publications

(16 reference statements)

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“…AKI patients' prognosis depends not only on the disease's etiology but also on the methods of diagnosis and management used in each medical setting [8]. Recent studies further proved that a larger hospital volume or case volume leads to better clinical outcomes in patients with various diseases, such as sepsis [9,10], leukemia [11], and those requiring surgery [12,13].…”

Section: Although Considerable Efforts Have Been Made To Tacklementioning

confidence: 99%

Correlation between the Incidence and Attributable Mortality Fraction of Acute Kidney Injury: A Systematic Review

et al. 2020

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Introduction: The incidence of acute kidney injury (AKI) as diagnosed by international standardized criteria as well as its mortality has undergone extreme variations. Although AKI is a significant worsening mortality factor, a higher prevalence may lead to better patient management, thereby lowering mortality. We investigated the correlation between AKI incidence and its associated mortality. Methods: We conducted a systematic review of studies on AKI reporting its incidence and mortality. Literature searches were performed in MEDLINE, EMBASE, and Cochrane Library, within the time frame of 2004-2018. Studies with small number of participants (< 500 for adult cohorts, 50 for pediatric cohorts) were excluded. The correlation among AKI incidence, mortality, and AKI-attributable fraction of mortality was evaluated using a regression model. The trend test was used to analyze the effect of publication year and country gross domestic product (GDP). Results: A total of 4,694 manuscripts were screened, from which 287 cohorts were eligible (adults: 203 cohorts comprising 7,076,459 patients; children: 84 comprising 69,677 patients). Within adult cohorts, AKI patients' mortality increased (R 2 = 0.023, β = 0.12, p = 0.03) but the attributable fraction of mortality decreased (R 2 = 0.27, β =-0.43, p < 0.001) with the increasing AKI incidence. Both more recent publications and higher GDP countries had a lower crude AKI patients' mortality, although AKI-attributable fraction did not decrease. Conclusions: Cohorts with high AKI incidence had a relatively low AKI-attributable mortality fraction, which suggests an advantage of more experienced AKI management. Further study is needed, however, to address the heterogeneity of included cohorts and to confirm the causality. (Registered in prospective register of systematic reviews database; CRD 42019129322.)

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Section: Although Considerable Efforts Have Been Made To Tacklementioning

confidence: 99%

Correlation between the Incidence and Attributable Mortality Fraction of Acute Kidney Injury: A Systematic Review

et al. 2020

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“…AML occurs mostly in elderly patients whose age is older when diagnosed, and their therapeutic efficacy and tolerance are significantly worse with age (3). In addition, there are often bleeding, infection or other adverse symptoms during the onset and treatment of the disease, which usually means worse prognosis (1). Therefore, the key to the diagnosis and treatment of AML is how to ensure the efficacy on AML patients while finding a safer treatment regimen.…”

Section: Discussionmentioning

confidence: 99%

“…Its annual incidence is 3–4 patients per 100,000 people and its 5-year mortality is 75%. The incidence of its onset is increasing with age (1–3). Myeloid archaeocytes clonally proliferate in peripheral blood or bone marrow, which is the characteristic of AML (4).…”

Section: Introductionmentioning

confidence: 99%

Observation of clinical efficacy and toxic and side effects of pirarubicin combined with cytarabine on acute myeloid leukemia

Haijuan

et al. 2019

Oncol Lett

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Efficacy and toxic and side effects of pirarubicin combined with cytarabine and mitoxantrone combined with cytarabine on the treatment of initially treated acute myeloid leukemia (AML) were compared. A retrospective analysis was performed on the medical records of 76 AML patients who were initially treated in Weifang People's Hospital. Among them, 36 patients (observation group) were treated with pirarubicin combined with cytarabine, and 40 patients (control group) were treated with mitoxantrone combined with cytarabine. The efficacy and toxic and side effects on patients in the two groups were observed. There was no statistically significant difference in the complete response (CR) rate, partial response (PR) rate and overall response (OR) rate of patients between the two groups (P>0.05). Patients in the observation group had significantly lower incidence of cardiotoxicity and alopecia than those in the control group (P<0.05). Patients in the observation group had lower incidence of bone marrow depression (BMD) at grade IV than those in the control group (P<0.05). The median progression-free survival time of patients was 14.5 months in the observation group and 18 months in the control group. The progression-free survival rate of patients was 36.11% in the observation group and 40.00% in the control group, with no difference between the two groups (P>0.05). The median survival time of patients was 22.5 months in the observation group and 24.5 months in the control group. The overall survival (OS) rate of patients was 44.44% in the observation group and 47.50% in the control group, with no difference between the two groups (P>0.05). Both pirarubicin combined with cytarabine and mitoxantrone combined with cytarabine have satisfactory efficacy on initially treated AML. Compared to the latter, the former has lower toxic and side effects.

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“…Numerous prior studies have shown the beneficial effect of a large HV on clinical outcomes in a wide variety of diseases or in patients needing operations or procedures. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 A larger HV is associated with larger caseloads and increased experience, and greater numbers of surgeons or physicians, both of which potentially lead to favorable outcomes for patients. 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 Admissions to larger HV and DCV hospitals both were associated with lower in-hospital mortality, as expected, in a univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Recent attempts to clarify the association between hospital volume (HV) and in-hospital mortality showed that a larger HV is associated with increased survival in various diseases such as sepsis, breast cancer, chronic obstructive pulmonary disease, acute myeloid leukemia, peripheral arterial disease, and deep vein thrombosis, 7 , 8 , 9 , 10 , 11 , 12 , 13 as well as after surgical procedures. 14 , 15 HV is usually defined as the number of hospitalization cases 7 , 8 , 9 , 10 , 11 or specific procedures 12 , 13 , 14 , 15 at each hospital. Thus, a larger HV is associated with a greater number of case experiences, doctors with expertise in treating the disease, hospital infrastructure, and resources.…”

mentioning

confidence: 99%

Dialysis Case Volume Associated With In-Hospital Mortality in Maintenance Dialysis Patients

Mandai

Sato

Iimori

et al. 2018

Kidney International Reports

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IntroductionAccumulating evidence suggests that a large hospital volume (HV) is associated with favorable outcomes in various diseases or surgical procedures. The aim of this study is to clarify the correlation of HV and dialysis case volume (DCV) with in-hospital death in patients on maintenance dialysis.MethodsThe study cohort was derived from the Diagnosis Procedure Combination database, a national inpatient database in Japan, from 2012 to 2014. We included 382,689 admissions of maintenance dialysis patients over the age of 20 years in the analysis. HV was defined as the mean number of daily hospitalized patients, and DCV was defined as the mean number of annually hospitalized patients on maintenance dialysis. The primary outcome was in-hospital all-cause mortality, evaluated using multivariable logistic regression models across the respective quartiles of HV and DCV.ResultsThe mean age of participants was 69 ± 12 years; 94% were receiving hemodialysis, and 21,182 patients (5.5%) died after hospitalization. In unadjusted models, larger HV and DCV were both associated with lower in-hospital mortality. However, this association remained significant only for DCV after adjustment for potential confounders, with multivariable-adjusted odds ratios of 0.82 (95% confidence interval [CI], 0.79–0.85), 0.76 (95% CI, 0.73–0.80), and 0.68 (95% CI, 0.65–0.72) for DCV 249 to 432, 433 to 713, and ≥714 (vs. ≤ 248) admissions per year, respectively. Multivariable subgroup analyses determined that this association was independent of age, sex, dialysis modality, Charlson Comorbidity Index, and emergency admission.ConclusionSelective admission to hospitals with a large DCV may improve outcomes of dialysis patients.

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Hospital volume and acute myeloid leukemia mortality in Medicare beneficiaries aged 65 years and older

Abstract: Acute myeloid leukemia (AML) is a fast-growing and lethal malignancy of the blood and bone marrow, with a 5-year mortality rate of 75%.

Cited by 13 publications

References 21 publications

Correlation between the Incidence and Attributable Mortality Fraction of Acute Kidney Injury: A Systematic Review

Correlation between the Incidence and Attributable Mortality Fraction of Acute Kidney Injury: A Systematic Review

Observation of clinical efficacy and toxic and side effects of pirarubicin combined with cytarabine on acute myeloid leukemia

Dialysis Case Volume Associated With In-Hospital Mortality in Maintenance Dialysis Patients

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