Inhospital morbidity and mortality among acute myeloid leukemia patients admitted for hematopoietic stem cell transplantation between 2002‐2017

Abstract

Acute myeloid leukemia (AML) is a disease with a poor prognosis, with a 28% 5-year survival rate. 1 The incidence of AML increases with age which leads to an older population with multiple comorbidities and inferior prognosis. 2 Allogenic hematopoietic stem cell transplant (ASCT) remains the standard of care in most intermediate and high-risk AML patients. 2 However, ASCT puts these patients at risk of severe cytopenia, opportunistic infections, acute graft versus host disease, and financial stress. 3 These complications are particularly frequent during the early phases of treatment. 3The National Inpatient Sample (NIS) is a database that provides information on all inpatient hospitalizations in the United States, including primary and secondary diagnoses, procedures, length of stay, and disposition. Approximately 20% of admissions are tracked, and weighted estimates are provided regarding the total number of hospitalizations in the United States. 4 Using this database, we were able to track hospital admissions for AML patients who underwent ASCT. We analyzed the characteristics of patients, trends in admissions for ASCT, in-hospital mortality, and length of stay in AML patients over a period of 16 years.Admissions for ASCT for AML patients were identified using a procedural clinical classification software code for bone marrow transplants in combination with ICD-9 codes for AML. Annual trends in mortality, hospital length of stay, and cost of admission were assessed with a linear regression analysis. Univariate logistic regression analysis was used to test for associations between chronic medical conditions and mortality among these patients. Comorbid conditions were identified using corresponding discharge billing ICD-10 for underlying chronic conditions in patients between 2016 and 2017.

Analysis of the Influence of Serum MMP‐2 and vWF Levels on the Predictive Value of Risk Grade and Prognosis of Patients with Acute Myeloid Leukemia

“…AML can invade various organs such as the liver, spleen, and lymph nodes, threatening people's life safety [ 1 , 2 ]. The acute leukemia incidence of AML is at higher levels, about 1.62/10 [ 3 ], and still has the growth of the clinical manifestation of bleeding, infection, and symptoms such as abnormal temperature rise and the body metabolic disorder, and due to the nature of the cells in patients with drug resistance increased and reduced sensitivity to drugs, only 20% of the patients can be fully cured; these diseases have a high recurrence rate [ 4 , 5 ], and these diseases are characterized by acute onset. The risk level of newly diagnosed cases is mostly medium-risk type.…”