PRO30 MORTALITY, MORBIDITY, SERIOUS INFECTIONS AND BURDEN OF HOSPITALIZATIONS IN PRIMARY IMMUNODEFICIENCY DISEASE (PID) PATIENTS WITH LOW AND HIGH COMORBIDITY INDEX: A PROPENSITY SCORE MATCHED ANALYSIS OF IN-PATIENT CLAIMS DATABASE

Abstract

To examine trends in mortality, morbidity, hospital length and cost of stay in PID patients with low and high comorbidity index. The latest available 2016 National Inpatient Sample (NIS) data set was utilized to determine the number of hospital admissions for patients with PID. Propensity score matched analysis was conducted to compare mortality hospital, LOS and costs in patients with low and high comorbidity index. 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 114,100 hospitalizations with a diagnosis of PID. Approximately 52% and 48% had comorbidity index of <3 and ≥ 3, respectively. The mean age was 39.9 (SD 25.6) and 61.1 (SD 17.8) in low and high comorbidity groups, respectively. Most common comorbidities were congestive heart failure (16.5%), cardiac arrhythmias (20.3%), hypertension (32.3%), chronic pulmonary disease (32.6%), diabetes (11.3%), renal failure (21.1%), lymphoma (10.0%), rheumatoid arthritis (10.0%) and depression (16.5%). The overall rate of serious infections was 45.3% (39.8% in low versus 47.9% in high comorbidity group, P<0.0001). The propensity score matched hospital LOS was 6.1 and 9.6 days, with a statistically significant difference of 3.5 days (SE 1.29, P<0.05), and hospital charges were $49,896 and $116,801, with a statistically significant difference of $66,905 (SE $20,533, P<0.05), in low and high comorbidity groups, respectively. Mortality rate was 1.9% and 6.3% in low and high comorbidity groups, respectively (P<0.0001). PID patients with high comorbidity index incur significantly longer hospital length of stay and more than 2 times the costs and 3 times the mortality compared to patients with low comorbidity index. There is a need for better treatment management for PID patients with high comorbidity index.