Abstract

To examine trends in hospital length of stay and total costs in NHL patients with and without Hematopoietic Stem Cell Transplant (HSCT). The latest available 2016 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 patients with NHL. Propensity score matched analysis was conducted to compare hospital LOS and costs in NHL patients with and without HSCT. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs. In 2016, there were an estimated 162,300 hospitalizations with a diagnosis of NHL, of which 1735 also had a procedure code for HSCT. The mean age was 58.3 (SD 10.8) and 65.9 (SD 15.7) in NHL patients with and without HSCT, respectively. 38.3% and 45.3% were female in NHL with and without HSCT, respectively. Most common comorbidities (more than 10%) were congestive heart failure (16.8%), cardiac arrhythmias (25.0%), hypertension (41.2%), chronic pulmonary disease (19.1%), diabetes (14.1% complicated, 10.0% complicated), renal failure (17.1%), coagulopathy (14.6%) and depression (12.6%). The propensity score matched hospital LOS was 22.6 and 5.7, with a statistically significant difference of 16.9 days (SE 0.73, P<0.05), in NHL patients with and without HSCT. The propensity score matched hospital charges were $375,123 and $53,113, with a statistically significant difference of $322,009 (SE $19708, P<0.05), in NHL patients with and without HSCT. Predictor variables for hospital LOS and costs were HSCT, weight loss, congestive heart failure, cardiac arrhythmias and anemia. NHL patients with HSCT incur significantly longer hospital length of stay and nearly 7 times the costs compared to patients without HSCT. There is a need for better treatment management for patients with NHL undergoing HSCT.

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