PB2333: BURDEN OF HOSPITALIZATION, COSTS AND CO-MORBIDITIES IN MEDICARE PATIENTS WITH CHRONIC GRAFT VERSUS HOST DISEASE: ANALYSIS OF NATIONAL IN-PATIENT HOSPITAL DATABASE

Abstract

Background: Chronic graft-versus-host disease (cGvHD) is a severe complication of allogeneic hematopoietic stem cell transplantation that affects various organs leading to a reduced quality of life. Aims: To analyze trends in hospital length of stay, total costs and co-morbidities in Medicare patients with Chronic Graft Versus Host Disease (CGVHD). Methods: The National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for Chronic Graft Versus Host Disease. Thirty co-morbidities were assessed using Elixhauser scoring. The outcomes assessed included length of stay (LOS), total charges, co-morbidity score, mortality rate and emergency room visits. Results: There were an estimated 5950 hospitalizations with a diagnosis of CGVHD, with 44% of the patients being covered by Medicare. The mean age was 57 (SD 14.54) years and 41% of the patients were female. The mean hospital length of stay for Medicare patients with CGVHD was 9.29 (SD 15.17) days (Median was 5 days). The mean hospital charges were $108,875 (SD $245171). The mean comorbidity score was 3.74 (SD 1.88, Median score was 4). The in-hospital mortality rate was 6.38%. The vast majority of the patients were White (79%), followed by Hispanic (9%), Black (7%) and Asian (2%). The top five co-morbid conditions were Fluid and Electrolyte Disorders (45%), Hypertension (39%), Depression (26%), Chronic Pulmonary Disease (25%) and Renal Failure (24%). The top 3 primary diagnosis codes were for Sepsis, Complications of stem cell transplant and Pneumonia. Summary/Conclusion: Chronic Graft Versus Host Disease poses significant burden on Medicare with high hospital charges and long LOS. There is a need for new treatment options for cGVHD patients.