OBJECTIVES

To compare the length of stay, hospitalization cost, and risk of in-hospital mortality among patients with chronic lymphocytic leukemia (CLL) in the United States discharged with and without tumor lysis syndrome (TLS).

METHODS

We performed a cross-sectional study of records with all-listed diagnoses of CLL and TLS identified using ICD-9 codes in the Healthcare Cost and Utilization Project's National Inpatient Sample (NIS) of discharges in 2014. The 2014 NIS data contains information from 4,411 hospitals with 7,071,762 records corresponding to 35,358,818 discharges. Each record represents a hospitalization. Appropriate weights and cost-to-charge ratio were used to convert charges into undiscounted cost estimates.

RESULTS

There were an estimated 70,350 (95% confidence interval [CI]: 68,263-72,437) and 585 (95% CI: 581-589) patient discharges recorded for CLL alone and CLL with TLS, respectively in 2014. The average length of stay for a CLL-related hospitalization with TLS was found to be 10.12 days (95% CI: 8.40-11.84), which is 73% higher than that of the patients discharged with CLL alone (5.84 days, 95% CI: 5.73-5.95). The average cost of CLL-related hospitalizations with TLS was found to be US$24,365 (95% CI: US$18,079-US$30,652), which is 39% higher than that of patients discharged with CLL alone (US$17,575; 95% CI: US$16,829-US$18,321). The mean age of patients discharged with both CLL and TLS was 71.7 years (95% CI: 69.9-73.6) compared with 75.3 years (95% CI: 75.0-75.5) for those with only CLL. Seventy-five percent of discharges with both conditions were male compared with 60% of those discharged with CLL. Unadjusted in-hospital mortality risk in patients with CLL and TLS was 18.8% (95% CI: 13.4%-24.3%) versus 5.6% (95% CI: 5.3-6.0) among patients discharged with CLL alone.

CONCLUSIONS

Inpatients with both CLL and TLS had longer hospital stay, higher hospitalization costs, and faced greater risk of mortality than patients discharged with CLL alone.