Hospitalizations for multiple myeloma in the United States from 2011 to 2019: An analysis of trends and disparities.
Authors: Zeeshan Solangi, Emeka Agudile, Arun Kumar, Ghulam Shah, Amirta Devi, Yusuf Yalcin, Ahda Solangi, Olga N. Kozyreva, Darren M. Evanchuk
Journal: Journal of Clinical Oncology (2024)

e19519 Background: The incidence and mortality rates of multiple myeloma have been increasing in recent decades, particularly among older adults. Understanding the trends and disparities in hospitalizations for this disease is crucial for informing healthcare resource allocation and improving patient outcomes. Methods: Our study examined trends and disparities in hospitalization for multiple myeloma, plasmacytoma and plasma cell leukemia in the US from 2011 to 2019, utilizing data from the Nationwide Inpatient Sample (NIS) database. We focused on patients aged 18 and above with specific ICD diagnosis codes. Our main objectives included analyzing admission numbers, discharge rates, length of stay, hospitalization costs, and mortality rates, using Stata version 15.1. Appropriate discharge weights were used in the analysis to address critical elements of sampling design, and a p-value of &lt;0.05 was deemed statistically significant. Results: Overall, there was a significant increase in both the absolute number and frequency of admissions from 20,584 in 2011 to 25,373 in 2019 (P &lt; 0.001), while the length of stay remained stable at 5.8 days in 2011 and 6.1 days in 2019. Hospitalization costs also rose significantly, with mean charges per patient increasing by 36.3% from $72,680.65 in 2011 to $99,065.22 in 2019 (P &lt; 0.001). The total aggregate cost for hospitalizations with multiple myeloma as the discharge diagnosis increased from $1.50 billion in 2011 to $2.51 billion in 2019 (inflation adjusted) (P &lt; 0.001). Although the absolute number of mortality cases increased from 2011 to 2019, there was a significant decrease in mortality rate over the same period from 5.7% in 2011 to 4.8% in 2019 (P &lt; 0.001). Analyses uncovered disparities in hospitalizations across various demographics such as age, race/ethnicity, payer type, income, and hospital characteristics. The 65-84 age group exhibited the highest increase in discharge rates (31%), followed by the 45-64 group (13.9%), with all age groups except 18-44 showing increases. African-Americans had the highest frequency of discharges, followed by Hispanics and Asian/Pacific Islanders. While White patients had the highest absolute numbers of multiple myeloma discharges, their increase in discharge frequency was not statistically significant. Discharge frequency rose for all payer groups, with the largest increase seen among medicare patients. Disparities were also observed based on income, with the greatest increase in the 51st-75th percentile income group. Urban teaching hospitals had the highest absolute number and frequency of discharges, followed by urban non-teaching and rural hospitals. Conclusions: These findings highlight the rising burden of multiple myeloma hospitalizations in the United States and underscore the need to address existing disparities in access to care and treatment outcomes.