Comparison of Disposition and Complications in Geriatric (≥ 65 years) and Non-Geriatric (50-64 years) Cancer Patients Receiving Hematopoietic Stem Cell Transplantation

Background:.The disposition and complications of hematopoietic stem cell transplant (HSCT) in the geriatric population has not been extensively studied and compared with younger patients. We have analyzed a database with nationwide representation for outcomes of HSCT in these patients over a 12 year period.

Methods: Data regarding patients who underwent HSCT was extracted from the Nationwide Inpatient Sample (NIS) from 2000 to 2011 using ICD-9-CM codes. HSCT hospitalizations were classified into allogeneic transplantation, autologous transplantation, subsequent hospitalization (s/p transplant) with graft versus host disease (GVHD) and subsequent hospitalization (s/p transplant) with other complications. NIS variables were used to identify in-hospital complications and discharge disposition. Chi square test and Wilcoxon rank test were used to compare categorical and continuous variables respectively.

Results: The proportion of elderly patients (≥ 65 years) receiving autologous transplants and being discharged to nursing homes has increased over the past decade when compared to a younger patient population. Notably, the rate of major complications: mechanical ventilation, tracheostomy and requirement of new dialysis are similar in both the patient populations. The trends from 2000 to 2011 are summarized in Table 1.

Conclusion: Although the rate of transplant-associated complications are similar in geriatric and non-geriatric populations, a higher percentage of geriatric cancer patients who receive HSCT are discharged to nursing homes. These rates have not significantly changed over the past decade (p > 0.05). More medical services and resources will be required to support the growing elderly population undergoing HSCT.

Table 1

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Table 1

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