Graft‐versus‐host disease in patients with bone marrow transplants: A retrospective study analyzing outcomes and healthcare burden in US hospitals

• Published in: European journal of haematology 2024-12, Vol.113 (6), p.758-764
• Main Authors: Patel, Rushin, Onyechi, Afoma, Ohemeng‐Dapaah, Jessica, Patel, Mrunal, Patel, Darshil, Patel, Zalak, Chen, Yu‐Han, Yang, Chieh
• Format: Article
• Language: English
• Subjects: Adult; Aged; Bone marrow; Bone marrow transplantation; Bone Marrow Transplantation - adverse effects; bone marrow transplants; Clinical outcomes; Confounding (Statistics); Cost of Illness; Female; Graft vs Host Disease - epidemiology; Graft vs Host Disease - etiology; Graft vs Host Disease - mortality; Graft-versus-host reaction; graft‐versus‐host disease; Health care; hospital charges; Hospital Mortality; Hospitalization; Hospitalization - economics; Hospitals; Humans; Length of Stay; Male; Mechanical ventilation; Middle Aged; Mortality; Odds Ratio; Patients; Pneumonia; Renal failure; Respiratory failure; Retrospective Studies; Sepsis; Stem cell transplantation; Treatment Outcome; United States - epidemiology
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14281

Background Graft‐versus‐host disease (GVHD) is a recognized complication among individuals undergoing bone marrow transplantation (BMT). There is a requirement for supplementary data regarding the in‐patient outcomes of GVHD in individuals who have undergone BMT. Our analysis seeks to assess the healthcare burden and outcomes associated with GVHD in hospitalized patients who have undergone BMT. Method In this retrospective study, we used data from the National Inpatient Sample (NIS) database spanning from 2016 to 2019. Utilizing ICD‐10 codes, we distinguished hospitalizations related to BMT and grouped them into two categories: those with GVHD and those without GVHD. Our areas of focus included in‐hospital mortality, length of stay, charges, and associations related to GVHD. Unadjusted odds ratios/coefficients were computed through univariable analysis, followed by adjusted odds ratios (aORs)/coefficients from multivariable analysis that considered potential confounding factors. Results From 2016 to 2019, data were collected from 13,999 hospitalizations with bone marrow transplants. Among them, 836 had GVHD cases. Patient characteristics showed slight differences in mean age and demographics between the two groups, with GVHD patients having a mean age of 51.61 years and higher percentages of males and whites. Analyzing outcomes, patients with GVHD experienced significantly longer hospital stays (41.4 days vs. 21.3 days) and higher total hospital charges ($824,058 vs. $335,765). Adjusting for confounding factors, GVHD posed a substantial risk. The aOR for mortality in GVHD hospitalizations was 7.20 (95% CI: 5.54–9.36, p