Table 3.
Trends over time in hematopoietic stem cell transplant indications, complications, intensive care unit therapies and outcomes.
| Early Time Period (2009–2013) (n = 204) |
Late Time Period (2014–2018) (n = 269) |
p (1) | Odds Ratio [95% CI] |
|
|---|---|---|---|---|
| Demographics | ||||
| Age, median [25%ile–75%ile], years | 7 [3–15] | 8 [3–14] | 0.73 | |
| Male (n, column %) | 116 (57) | 168 (62) | 0.22 | 0.79 [0.55–1.15] |
| Female (n, column %) | 88 (43) | 101 (38) | ||
| Transplant type | ||||
| Allogeneic (n, column %) | 119 (58) | 174 (65) | 0.16 (2) | 0.76 [0.53–1.11] |
| Autologous (n, column %) | 85 (42) | 95 (35) | ||
| Hospital outcome | ||||
| Overall | ||||
| Survivors (n, column %) | 181 (89) | 257 (96) | <0.01 (3) | 2.72 [1.32–5.61] |
| Deaths (n, column %) | 23 (11) | 12 (4) | ||
| Allogeneic | ||||
| Survivors (n, %allogeneic/column) | 98 (82) | 164 (94) | <0.01 (4) | 3.51 [1.59–7.77] |
| Deaths (n, %allogeneic/column) | 21 (18) | 10 (6) | ||
| Autologous | ||||
| Survivors (n, % autologous/column) | 83 (98) | 93 (98) | 1.00 (5) | 1.12 [0.15–8.13] |
| Deaths (n, % autologous/column) | 2 (2) | 2 (2) | ||
| Hospital LOS, median [25%ile–75%ile], days | 31 [23–47] | 33 [24–48] | 0.47 | |
| Transplant Indication (6) | 0.10 | |||
| Malignant Hematologic (n, column %) | 83 (41) | 138 (51) | ||
| Solid tumor (n, column %) | 76 (37) | 81 (30) | ||
| Non-malignant Hematologic (n, column %) | 29 (14) | 35 (13) | ||
| Immunodeficiency (n, column %) | 9 (4) | 12 (4) | ||
| Non-malignant other (n, column %) | 7 (3) | 3 (1) | ||
| Transplant Complication | ||||
| GVHD (n, %allogeneic transplant/column) (7) | 39 (33) | 57 (33) | 1.00 | 1.00 [0.61–1.64] |
| No GVHD (n, %allogeneic transplant/column) (7) | 80 (67) | 117 (67) | ||
| Any infectious complication (n, column %) | 68 (33) | 57 (21) | <0.01 | 0.54 [0.36–0.81] |
| No Infectious complication (n, column %) | 136 (67) | 212 (79) | ||
| ICU Therapies | ||||
| Any ICU Therapy (n, column %) | 58 (28) | 85 (32) | 0.46 | 0.16 [0.78–1.73] |
| No ICU Therapy (n, column %) | 146 (72) | 184 (68) | ||
| PPV (n, column %) | 29 (14) | 24 (9) | 0.07 | 0.59 [0.33–1.05] |
| No PPV (n, column %) | 175 (86) | 245 (91) | ||
| Dialysis (n, column %) | 8 (4) | 8 (3) | 0.57 | 0.75 [0.28–2.04] |
| No Dialysis (n, column %) | 196 (96) | 261 (97) | ||
| Vasoactive infusion (n, column %) | 41 (20) | 75 (28) | 0.05 | 1.54 [1.00–2.37] |
| No Vasoactive infusion (n, column %) | 163 (80) | 194 (72) | ||
CI, confidence interval; NS, not significant; LOS, length of stay; GVHD, graft-versus-host-disease; ICU, intensive care unit; PPV, positive pressure ventilation.
(1) Variable distributions in the early versus late time periods were compared. Continuous variables were compared with Wilcoxon rank sums tests, and categorical variables were compared with Pearson's χ2 or Fisher's Exact.
(2) Comparison of transplant type distribution (allogeneic/autologous), early vs. late time periods.
(3) Comparison of survival distribution for all transplant types, early vs. late time periods.
(4) Comparison of survival distribution for allogeneic transplants, early vs. late time periods.
(5) Comparison of survival distribution for autologous transplants, early vs. late time periods.
(6) See Supplementary Appendix for individual diagnoses included in each transplant indication subgroup.
(7) GVHD reported as percent of allogeneic transplants (total n = 293).