In-Hospital Mortality Among Patients with Multiple Myeloma in the United States: A 13-Year Perspective

Background:

Multiple myeloma (MM) is a rare hematologic malignancy that has a 2-4-fold increase in incidence rate and a 2-fold increase in mortality among African Americans compared to Caucasians. While there have been significant advancements in both treatment modalities and availability of agents over the past decade, there is little information regarding inpatient mortality patterns both at large and among racial and gender subgroups.

Methods: The National Inpatient Sample database was used to identify patients with MM between the years of 2000 and 2012. MM was defined using validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis (ICD9-CM) codes. Patient demographics, total hospital length of stay, and in-hospital mortality were analyzed.

Results:

Overall between the years of 2000 and 2012, a total of 1,041,021 patients with MM were admitted, out of which 6.8% died during hospitalization. Among the patients who died, 54.8% were male, and 55.9% were white. Overall, in-hospital mortality was decreased by 30.2% among patients with MM from 2000 to 2012. The mortality rate steadily decreased from 7.29% in 2000 to 4.48% in 2012 (P<0.001). No uniform trend was noted among hospitalized patients with respect to length of stay (P=0.8), gender (P = 0.81), and mortality per year between Caucasians and African Americans (p =0.14).

Conclusion:

While in-hospital length of stay for MM patients has not changed over the years, in-hospital mortality has significantly decreased between the years of 2000 and 2012. However, there is no significant difference in mortality trends between gender and racial groups, which differ from prior studies reporting increased mortality in African American patients.