Affiliation:
1. Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
2. Division of Healthcare Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
3. Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
4. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
Abstract
Abstract
The epidemiology and outcomes of tumor lysis syndrome (TLS) are understudied. We used the National Inpatient Sample (NIS), a nationally representative weighted sample of all U.S. hospital discharges, to study outcomes and predictors of mortality in hospitalized patients with TLS. The NIS was queried for patients with a discharge diagnosis of TLS (ICD-9 code 277.88) from 2010–2013. Baseline characteristics and outcomes were analyzed. A multivariable logistic regression analysis was performed to identify predictors of mortality. From 2010–2013, 28,370 patients were discharged with a diagnosis of TLS. The most common malignancies were non-Hodgkin lymphoma (30%), solid tumors (20%), acute myeloid leukemia (19%), and acute lymphocytic leukemia (13%). Overall in-hospital mortality was 21%. The median length of stay was 10 days (IQR 5-22). Sixty-nine percent of patients experienced a severe complication, including sepsis (22%, 95% confidence interval [CI] 21–23), dialysis (15%, 95% CI 14–16), acute respiratory failure (23%, 95% CI 22–24), mechanical ventilation (16%, 95% CI 15–17), gastrointestinal hemorrhage (6%, 95% CI 5–7), cerebral hemorrhage (2%, 95% CI 2–3), seizures (1%, 95% CI 0.6–1), and cardiac arrest (2%, 95% CI 2–3). Predictors of mortality were derived from a multivariable logistic regression and included age, Elixhauser comorbidity score, insurance status, teaching versus nonteaching hospital, and cancer type. Predictors of increased length of stay included age, race, teaching versus nonteaching hospital, and cancer type. In the U.S., many patients with TLS develop life-threatening complications and a quarter die during hospitalization. As more cancer treatments become available, strategies to improve the supportive care of patients with TLS should be a priority.
Publisher
Oxford University Press (OUP)
Cited by
45 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献