Abstract Topic: 22. Stem cell transplantation - Clinical
Background: Veno-occlusive disease (VOD), also called sinusoidal obstruction syndrome (SOS), is a potentially life-threatening complication of hematopoietic stem cell transplantation (HSCT) conditioning or high-dose nontransplant chemotherapy.
Aims: To compare hospitalizations with principal and secondary diagnosis of Veno-Occlusive Disease (VOD).
Methods: The National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to analyze hospital admission records for patients with VOD. Three cohorts of patients were designed: Any diagnosis, principal and secondary. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.
Results: In 2016, there were an estimated 200 hospitalizations with a diagnosis of VOD, with 35 as principal diagnosis and 165 as secondary. The mean ages in three groups were: 21.1 (SD 21.97), 15.29 (SD 21.48) and 22.33 (SD 22.2) years for any, principal and secondary diagnosis groups, respectively. Nearly half of all VOD patients were covered by Medicaid (48%-Any, 29%-Principal, 52%-Secondary). Majority of patients in each group were white (43%-Any, 57%-Principal,39%-Secondary). Interestingly, the mean length of stay was significantly higher in patients with secondary diagnosis (45.35-Any, 20.71-Principal, 50.57-Secondary, p<0.05). The mean hospital charges were also ~3 times higher in the secondary diagnosis group ($1,152,370-Any, $398,930-Principal, $1,312,191-Secondary, p<0.05). The top leading non-VOD principal diagnoses were Acute lymphoblastic leukemia and Acute kidney failure.
Summary/Conclusion: OD is a serious disorder with very long LOS and high hospital costs. This shows that patients with secondary diagnosis of VOD incur higher costs than those with principal diagnosis.
Keywords: Veno-occlusive disease