e18628 Background: Sepsis is a major cause of morbidity and mortality among patients with hematologic malignancies, yet outcome differences across major cancer subtypes remain incompletely characterized. We evaluated clinical outcomes and healthcare utilization among hospitalized sepsis patients with myeloma, leukemia, and lymphoma in the United States. Methods: We conducted a retrospective cohort study using the National Inpatient Sample (2016–2021). Adult hospitalizations with sepsis were identified using ICD-10 diagnosis codes. Hematologic malignancies were classified as myeloma, leukemia, or lymphoma. Outcomes included in-hospital mortality, ICU-level care, mechanical ventilation, dialysis, acute kidney injury, respiratory failure, septic shock, disseminated intravascular coagulation, venous thromboembolism, gastrointestinal bleeding, encephalopathy/delirium, length of stay, and hospitalization charges. Survey-weighted multivariable logistic regression was used for binary outcomes and linear regression for log-transformed length of stay and charges. Models adjusted for age, sex, race, payer, income quartile, hospital region, bed size, teaching status, and year. Results are reported as odds ratios (OR) with 95% confidence intervals (CI) and p values. Results: Among 108,807 sepsis hospitalizations with hematologic malignancy, mortality was 18.7%. Compared with myeloma, leukemia was associated with higher mortality (OR 1.28, 95% CI 1.23–1.34, p<0.001) and lymphoma (OR 1.24, 95% CI 1.19–1.30, p<0.001). For ICU-level care, leukemia (OR 0.85, 95% CI 0.83–0.89, p<0.001) and lymphoma (OR 0.93, 95% CI 0.90–0.97, p<0.001) had lower odds compared with myeloma. For mechanical ventilation, lymphoma had higher odds (OR 1.06, 95% CI 1.01–1.11, p=0.01) while leukemia did not differ significantly. For dialysis, leukemia (OR 0.45, 95% CI 0.42–0.47, p<0.001) and lymphoma (OR 0.46, 95% CI 0.43–0.49, p<0.001) had markedly lower odds compared with myeloma. For complications, leukemia and lymphoma were associated with higher odds of AKI (p<0.001), septic shock (p<0.001), respiratory failure (p<0.001), DIC (p<0.001), VTE (p<0.001), and encephalopathy (p<0.001), while GI bleeding did not differ significantly across subtypes (p=0.85). Increasing age, male sex, larger hospital size, and teaching status were independently associated with worse outcomes. Conclusions: Sepsis outcomes differ substantially by hematologic malignancy subtype. Leukemia and lymphoma carry significantly higher mortality, while myeloma is characterized by a markedly higher burden of dialysis. These malignancy-specific patterns highlight the need for tailored sepsis risk stratification and management strategies.
Oktrian et al. (Thu,) studied this question.