Sepsis and Acute Myeloid Leukemia: A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals

Imrana A. Malik, Marylou Cardenas-Turanzas, Susan Gaeta, Gautum Borthakur, Kristen Price, Jorge Cortes, Joseph L. Nates

Research output: Contribution to journalArticle

Abstract

Micro-Abstract We reviewed outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. AML patients (0.25% of > 2 million discharges) had a higher incidence of sepsis (16% vs. 4%) and of sepsis-related mortality (30% vs. 21%), with nearly double the hospital length of stay, compared to non-AML patients with sepsis. This information can increase awareness of the risk of sepsis and the need for early intervention in AML patients. Background In the United States, approximately 750,000 cases of sepsis occur annually, and 28% to 50% of affected people die. Treatment is costly, often involving admission to the intensive care unit and prolonged hospitalization. We evaluated outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. Patients and Methods We conducted a population-based cohort study of adults discharged from Texas hospitals during 2011, using ICD-9-CM codes and the Texas Inpatient Data Collection. Results A total of 2,173,776 adults were discharged from hospitals in Texas, and 5501 (0.25%) had a diagnosis of AML. Among patients with AML, 40% were ≥ 65 years old, and 52% were men. The rate of sepsis for AML patients was 16% compared to 4% for non-AML patients. Among patients with AML, sepsis was associated with pneumonia, acute renal failure, and hematologic dysfunctions in 34%, 32%, and 29% of discharges, respectively. Median length of stay, intensive care unit admission rate, and median hospital charges per stay for patients with AML and sepsis were 13 days (range, 1-133 days), 72%, and $122,333, respectively. Among in-hospital deaths due to sepsis, mortality was 30% in AML patients compared to 21% in non-AML patients. Conclusion Patients with AML had a higher sepsis incidence and higher mortality rates overall, especially in relation to stem-cell transplant recipients and those with other types of cancer. Clinical trials are needed to determine whether early intervention or treatment in specialized centers could improve outcomes and reduce costs of care, particularly in the management of serious complications such as sepsis.

Original languageEnglish (US)
Pages (from-to)e27-e32
JournalClinical Lymphoma, Myeloma and Leukemia
Volume17
Issue number12
DOIs
StatePublished - Dec 2017
Externally publishedYes

Fingerprint

Acute Myeloid Leukemia
Sepsis
Outcome Assessment (Health Care)
Population
Myeloid Leukemia
Length of Stay
Intensive Care Units
Mortality
Hospital Charges
Incidence
International Classification of Diseases
Acute Kidney Injury
Inpatients
Pneumonia
Hospitalization
Cohort Studies
Stem Cells
Clinical Trials

Keywords

  • AML
  • Cancer
  • Mortality
  • Outcomes
  • Sepsis

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Sepsis and Acute Myeloid Leukemia : A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals. / Malik, Imrana A.; Cardenas-Turanzas, Marylou; Gaeta, Susan; Borthakur, Gautum; Price, Kristen; Cortes, Jorge; Nates, Joseph L.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 17, No. 12, 12.2017, p. e27-e32.

Research output: Contribution to journalArticle

Malik, Imrana A. ; Cardenas-Turanzas, Marylou ; Gaeta, Susan ; Borthakur, Gautum ; Price, Kristen ; Cortes, Jorge ; Nates, Joseph L. / Sepsis and Acute Myeloid Leukemia : A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals. In: Clinical Lymphoma, Myeloma and Leukemia. 2017 ; Vol. 17, No. 12. pp. e27-e32.
@article{995eb0055fb04c4c9a27da81be4d4012,
title = "Sepsis and Acute Myeloid Leukemia: A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals",
abstract = "Micro-Abstract We reviewed outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. AML patients (0.25{\%} of > 2 million discharges) had a higher incidence of sepsis (16{\%} vs. 4{\%}) and of sepsis-related mortality (30{\%} vs. 21{\%}), with nearly double the hospital length of stay, compared to non-AML patients with sepsis. This information can increase awareness of the risk of sepsis and the need for early intervention in AML patients. Background In the United States, approximately 750,000 cases of sepsis occur annually, and 28{\%} to 50{\%} of affected people die. Treatment is costly, often involving admission to the intensive care unit and prolonged hospitalization. We evaluated outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. Patients and Methods We conducted a population-based cohort study of adults discharged from Texas hospitals during 2011, using ICD-9-CM codes and the Texas Inpatient Data Collection. Results A total of 2,173,776 adults were discharged from hospitals in Texas, and 5501 (0.25{\%}) had a diagnosis of AML. Among patients with AML, 40{\%} were ≥ 65 years old, and 52{\%} were men. The rate of sepsis for AML patients was 16{\%} compared to 4{\%} for non-AML patients. Among patients with AML, sepsis was associated with pneumonia, acute renal failure, and hematologic dysfunctions in 34{\%}, 32{\%}, and 29{\%} of discharges, respectively. Median length of stay, intensive care unit admission rate, and median hospital charges per stay for patients with AML and sepsis were 13 days (range, 1-133 days), 72{\%}, and $122,333, respectively. Among in-hospital deaths due to sepsis, mortality was 30{\%} in AML patients compared to 21{\%} in non-AML patients. Conclusion Patients with AML had a higher sepsis incidence and higher mortality rates overall, especially in relation to stem-cell transplant recipients and those with other types of cancer. Clinical trials are needed to determine whether early intervention or treatment in specialized centers could improve outcomes and reduce costs of care, particularly in the management of serious complications such as sepsis.",
keywords = "AML, Cancer, Mortality, Outcomes, Sepsis",
author = "Malik, {Imrana A.} and Marylou Cardenas-Turanzas and Susan Gaeta and Gautum Borthakur and Kristen Price and Jorge Cortes and Nates, {Joseph L.}",
year = "2017",
month = "12",
doi = "10.1016/j.clml.2017.07.009",
language = "English (US)",
volume = "17",
pages = "e27--e32",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
issn = "2152-2650",
publisher = "Cancer Media Group",
number = "12",

}

TY - JOUR

T1 - Sepsis and Acute Myeloid Leukemia

T2 - A Population-Level Study of Comparative Outcomes of Patients Discharged From Texas Hospitals

AU - Malik, Imrana A.

AU - Cardenas-Turanzas, Marylou

AU - Gaeta, Susan

AU - Borthakur, Gautum

AU - Price, Kristen

AU - Cortes, Jorge

AU - Nates, Joseph L.

PY - 2017/12

Y1 - 2017/12

N2 - Micro-Abstract We reviewed outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. AML patients (0.25% of > 2 million discharges) had a higher incidence of sepsis (16% vs. 4%) and of sepsis-related mortality (30% vs. 21%), with nearly double the hospital length of stay, compared to non-AML patients with sepsis. This information can increase awareness of the risk of sepsis and the need for early intervention in AML patients. Background In the United States, approximately 750,000 cases of sepsis occur annually, and 28% to 50% of affected people die. Treatment is costly, often involving admission to the intensive care unit and prolonged hospitalization. We evaluated outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. Patients and Methods We conducted a population-based cohort study of adults discharged from Texas hospitals during 2011, using ICD-9-CM codes and the Texas Inpatient Data Collection. Results A total of 2,173,776 adults were discharged from hospitals in Texas, and 5501 (0.25%) had a diagnosis of AML. Among patients with AML, 40% were ≥ 65 years old, and 52% were men. The rate of sepsis for AML patients was 16% compared to 4% for non-AML patients. Among patients with AML, sepsis was associated with pneumonia, acute renal failure, and hematologic dysfunctions in 34%, 32%, and 29% of discharges, respectively. Median length of stay, intensive care unit admission rate, and median hospital charges per stay for patients with AML and sepsis were 13 days (range, 1-133 days), 72%, and $122,333, respectively. Among in-hospital deaths due to sepsis, mortality was 30% in AML patients compared to 21% in non-AML patients. Conclusion Patients with AML had a higher sepsis incidence and higher mortality rates overall, especially in relation to stem-cell transplant recipients and those with other types of cancer. Clinical trials are needed to determine whether early intervention or treatment in specialized centers could improve outcomes and reduce costs of care, particularly in the management of serious complications such as sepsis.

AB - Micro-Abstract We reviewed outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. AML patients (0.25% of > 2 million discharges) had a higher incidence of sepsis (16% vs. 4%) and of sepsis-related mortality (30% vs. 21%), with nearly double the hospital length of stay, compared to non-AML patients with sepsis. This information can increase awareness of the risk of sepsis and the need for early intervention in AML patients. Background In the United States, approximately 750,000 cases of sepsis occur annually, and 28% to 50% of affected people die. Treatment is costly, often involving admission to the intensive care unit and prolonged hospitalization. We evaluated outcomes of patients with acute myeloid leukemia (AML) and sepsis in Texas. Patients and Methods We conducted a population-based cohort study of adults discharged from Texas hospitals during 2011, using ICD-9-CM codes and the Texas Inpatient Data Collection. Results A total of 2,173,776 adults were discharged from hospitals in Texas, and 5501 (0.25%) had a diagnosis of AML. Among patients with AML, 40% were ≥ 65 years old, and 52% were men. The rate of sepsis for AML patients was 16% compared to 4% for non-AML patients. Among patients with AML, sepsis was associated with pneumonia, acute renal failure, and hematologic dysfunctions in 34%, 32%, and 29% of discharges, respectively. Median length of stay, intensive care unit admission rate, and median hospital charges per stay for patients with AML and sepsis were 13 days (range, 1-133 days), 72%, and $122,333, respectively. Among in-hospital deaths due to sepsis, mortality was 30% in AML patients compared to 21% in non-AML patients. Conclusion Patients with AML had a higher sepsis incidence and higher mortality rates overall, especially in relation to stem-cell transplant recipients and those with other types of cancer. Clinical trials are needed to determine whether early intervention or treatment in specialized centers could improve outcomes and reduce costs of care, particularly in the management of serious complications such as sepsis.

KW - AML

KW - Cancer

KW - Mortality

KW - Outcomes

KW - Sepsis

UR - http://www.scopus.com/inward/record.url?scp=85028040606&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85028040606&partnerID=8YFLogxK

U2 - 10.1016/j.clml.2017.07.009

DO - 10.1016/j.clml.2017.07.009

M3 - Article

C2 - 28844403

AN - SCOPUS:85028040606

VL - 17

SP - e27-e32

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2650

IS - 12

ER -