PRO22 Hospital Length of Stay, Total Costs and Comorbidities in Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH): Analysis of National In-patient Hospital Database

Abstract

To analyze trends in hospital length of stay, total costs and comorbidities in patients with Paroxysmal Nocturnal Hemoglobinuria (PNH). The 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 PNH. Propensity score matched analysis was conducted to compare hospital LOS and costs in patients with low and high LOS. 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 910 hospitalizations with a diagnosis of PNH. The mean age was 48.54 (SD 20.67) years and 48% of the patients were female. Payer distribution was 38%, 27% and 31% for Medicare, Medicaid and Private, respectively. The majority of the patients were White (57%), followed by Black (18%) and Hispanic (16%). The mean LOS of 5.74 (SD 7.81) days, with longer LOS for patients covered under Medicaid versus Medicare (6.16 [SD 7.89] vs 4.09 [SD 2.93] days). The total hospital charges were $88251 (SD $166886), with almost double charges in Medicaid versus Medicare ($91086 vs $52435). Most common comorbidities were Coagulopathy (27%), Hypertension, Uncomplicated (28%), Renal Failure (17%) and Cardiac Arrhythmias (17%). Approximately 61% of hospitalizations were associated with an emergency department visit. Paroxysmal Nocturnal Hemoglobinuria (PNH) leads to high resource use and long hospital length of stay. There is a need for better management of patients with PNH.