To examine trends in hospital length of stay and total costs in MM patients with and without Hematopoietic Stem Cell Transplant (HSCT).

METHODS: 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 MM. Propensity score matched analysis was conducted to compare hospital LOS and costs in MM 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.

RESULTS:

In 2016, there were an estimated 108,170 hospitalizations with a diagnosis of MM, of which 4480 also had a procedure code for HSCT. The mean age was 60.6 (SD 8.6) and 69.8 (SD 11.6) in MM patients with and without HSCT, respectively. 45.7% and 45.0% were female in MM with and without HSCT, respectively. Most common comorbidities (more than 10%) were congestive heart failure (23.7%), cardiac arrhythmias (28.3%), hypertension (35.1%), chronic pulmonary disease (19.7%), diabetes (14.3% uncomplicated, 13.4% complicated), renal failure (39.9%), coagulopathy (19.7%) and depression (12.7%). The propensity score matched hospital LOS was 16.9 and 6.7, with a statistically significant difference of 10.2 days (SE 0.25, P<0.05), in MM patients with and without HSCT. The propensity score matched hospital charges were $196,457 and $69,903, with a statistically significant difference of $126,553 (SE $3617, P<0.05), in MM patients with and without HSCT. Predictor variables for hospital LOS and costs were HSCT, weight loss, cardiac arrhythmias and coagulopathy.

CONCLUSIONS: MM patients with HSCT incur significantly longer hospital length of stay and nearly 3 times the costs compared to patients without HSCT. There is a need for better treatment management for patients with MM undergoing HSCT.