Disparities in Outcomes of Hospitalizations Due to Multiple Myeloma: A Nationwide Comparison

Sushmita Khadka; Swetha Balaji; Japjeet Kaur; Dhanshree Solanki; Mariia Kasianchyk; Humayra Chowdhury; Ishani Patel; Muhammad Qasim; Maheshkumar Desai; Prakash Maiyani; Dharmeshkumar V Moradiya; Darshan Lal; Achint A Patel; Manidhar Lekkala

doi:10.7759/cureus.47319

Disparities in Outcomes of Hospitalizations Due to Multiple Myeloma: A Nationwide Comparison

Cureus. 2023 Oct 19;15(10):e47319. doi: 10.7759/cureus.47319. eCollection 2023 Oct.

Authors

Affiliations

¹ Internal Medicine, Guthrie Robert Packer Hospital, Sayre, USA.
² Medicine, Scripps Clinic John R. Anderson V Medical Pavilion, San Diego, USA.
³ Medicine, Sub-divisional Civil Hospital, Ajnala, IND.
⁴ Hospital Administration, Rutgers University, New Brunswick, USA.
⁵ Medicine, Vinnytsia National Medical University, Vinnytsia, UKR.
⁶ Medicine, Mount Sinai Health System, New York, USA.
⁷ Medicine, Houston Medical Center, Warner Robins, USA.
⁸ Internal Medicine, Hospital Corporation of America (HCA) Healthcare/University of South Florida (USF) Morsani College of Medicine Graduate Medical Education (GME) Oak Hill Hospital, Brooksville, USA.
⁹ Internal Medicine, Hamilton Medical Center, Medical College of Georgia/Augusta University, Dalton, USA.
¹⁰ Internal Medicine, Gold Coast University Hospital, Southport, AUS.
¹¹ Internal Medicine, St. John of God Murdoch Hospital, Murdoch, AUS.
¹² Hospital Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA.
¹³ Oncology, University of Kansas, Kansas City, 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.

Keywords: length of stay; multiple myeloma; multiple myeloma prognosis; multiple myeloma treatment; newest treatment for multiple myeloma; temporal trends.