Risk factors for length of stay and charge per day differ between older and younger hospitalized patients with AML

摘要

Acute myeloid leukemia (AML) is associated with frequent hospitalizations. We evaluated factors associated with length of stay (LOS) and charge per day (CPD) for admissions in older (≥60 years) and younger patients (<60 years). We identified patients with ICD‐9‐CM codes for AML or myeloid sarcoma in the 2012 HCUP‐NIS. In separate models based on age, we examined patient (sex, race, income, insurance payer, chronic conditions, chemotherapy administration, death) and hospital (type, geography) characteristics. Multivariable negative binomial regression estimated factor effects on LOS and CPD using rate ratios, with HCUP‐NIS weights. In 43,820 discharges, LOS was longer in patients <60 than ≥60 (6.8 vs. 5.4 days). For patients <60, longer LOS was seen with more chronic conditions (RR = 1.10), Black race (RR = 1.16), chemotherapy ( style="fixed-case">RR = 2.27), and geography; shorter style="fixed-case">LOS was associated with older age ( style="fixed-case">RR = 0.93), Medicare ( style="fixed-case">RR = 0.83), and hospital type. For patients ≥60, longer style="fixed-case">LOS associated with chronic conditions ( style="fixed-case">RR = 1.07) and Asian race ( style="fixed-case">RR = 1.33). Shorter style="fixed-case">LOS associated with older age ( style="fixed-case">RR = 0.86), higher income ( style="fixed-case">RR = 0.93), and hospital type. For patients <60, higher style="fixed-case">CPD associated with chronic conditions ( style="fixed-case">RR = 1.05), death ( style="fixed-case">RR = 1.93), and geography; lower style="fixed-case">CPD associated with increasing age ( style="fixed-case">RR = 0.96), Medicaid ( style="fixed-case">RR = 0.93), and rural hospitals ( style="fixed-case">RR = 0.65). For patients ≥60, higher style="fixed-case">CPD associated with Medicare ( style="fixed-case">RR = 1.05), more chronic conditions ( style="fixed-case">RR = 1.02), younger age ( style="fixed-case">RR = 1.1), west geography ( style="fixed-case">RR = 1.37), death ( style="fixed-case">RR = 1.45), and Hispanic race ( style="fixed-case">RR = 1.15). We identify predictors for increased healthcare utilization in hospitalized patients with style="fixed-case">AML, which differ within age groups. Future efforts are needed to link utilization outcomes with clinical treatments and response.