e18615 Background: Acute myeloid leukemia (AML) is an aggressive hematologic malignancy associated with high morbidity, frequent hospitalizations, and substantial healthcare resource utilization despite therapeutic advances. Contemporary real-world data on inpatient outcomes among adults with AML remain limited. We evaluated inpatient hospitalization outcomes and resource utilization in this population. Methods: A retrospective study using the National Inpatient Sample identified adult AML hospitalizations from 2021-2022. Sociodemographic variables included age, sex, race/ethnicity, and insurance. Primary outcomes were in-hospital mortality, length of stay (LOS), and costs; secondary outcomes included sepsis, acute kidney injury, respiratory failure, mechanical ventilation, and dialysis. Multivariable regression identified factors independently associated with inpatient outcomes. Results: Among 126, 940 hospitalizations, the median age was 66 years; patients were predominantly male and White (71. 0%). Medicare (51. 7%) and private insurance (32. 1%) were the most common payers. Median LOS was 6 days, with 41. 8% lasting >8 days. During hospitalization, 20. 7% developed sepsis, 18. 2% respiratory failure, and 4. 8% required invasive mechanical ventilation. The median cost per hospitalization was 75, 000, and in-hospital mortality was 8. 6%. In multivariable analyses, older age was associated with higher inpatient mortality (adjusted OR, 1. 46; P <0. 001), shorter length of stay (−2. 40 days; P <0. 001) and lower total hospital charges (−50, 121; P <0. 001). Female sex, compared with male sex, was associated with lower odds of inpatient mortality (adjusted OR, 0. 88; P <0. 001), slightly shorter hospitalizations (−0. 16 days; P =0. 047), and lower hospitalization charges (−11, 839; P <0. 001). Compared with White patients, Black patients experienced significantly higher inpatient mortality (adjusted OR, 1. 48; P <0. 001) despite shorter length of stay (−0. 75 days; P <0. 001) and lower hospital charges (−39, 542; P <0. 001). Insurance type and median household income were independently associated with all outcomes; higher income quartiles were associated with lower inpatient mortality (adjusted OR, 0. 96 per quartile; P <0. 001) but longer hospitalizations and higher costs (both P <0. 001). Across all models, critical illness severity was the strongest predictor of adverse outcomes, conferring markedly increased inpatient mortality (adjusted OR, 12. 84; P <0. 001), longer length of stay (+4. 61 days; P <0. 001), and higher hospitalization charges (+108, 392; P <0. 001). Conclusions: AML hospitalizations are characterized by high morbidity and mortality, with illness severity as the primary driver of outcomes. However, independent associations between race, socioeconomic factors, and inpatient outcomes indicate opportunities to improve risk stratification and optimize inpatient management strategies.
Amaeshi et al. (Thu,) studied this question.