PRO25 Trend in Hospital Length of Stay, Costs and Comorbidities in Patients with Veno-Occlusive Disease (VOD): Analysis of National in-Patient Hospital Database

Abstract

To analyze trends in hospital length of stay, total costs and comorbidities in patients with Veno-Occlusive Disease (VOD). 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 VOD. 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 200 hospitalizations with a diagnosis of VOD. The mean age was 21.1 (SD 21.97) years and 35% of the patients were female. Interestingly, nearly half of the patients were insured by Medicaid (48%) and rest by Private (40%) and Medicare (8%). Majority of the patients were White (43%) or Hispanic (30%). The LOS was very long, with a mean LOS of 45.35 (SD 39.48) days. LOS significantly varied by ethnicity (32.76 [SD 31.69] versus 52.08 [SD 45.87 days for White and Hispanic, respectively). The total hospital charges were very high, with mean charges of $1.15 million. Total charges also significantly varied by ethnicity ($0.76 million versus $1.51 million for White and Hispanic, respectively). Most common comorbidities were Coagulopathy (38%), Cardiac Arrhythmias (18%) and Hypertension (15%). Approximately 18% of hospitalizations were associated with an emergency department visit. Veno-Occlusive Disease (VOD) leads to high resource use and long length of stay. There is a need for better management of patients with VOD.