Background: As hematopoietic stem cell transplant (HSCT) grows in accessibility and utility, it remains imperative to understand outcomes for its recipients. Limited data is available on the race-based correlations for this steadily increasing patient population. We sought to examine the National Inpatient Sample (NIS) database to describe in-hospital outcomes among the black population who have received a HSCT.

Methods: Data were extracted from the NIS Database from 2019 and 2020. The NIS was searched for hospitalizations of all patients greater than 18 years old who had previously received a HSCT and were hospitalized thereafter. We then analyzed the outcomes of patients who were identified as black. Multivariate logistic regression analysis was used to adjust for confounders; SPSS software was used for statistical analysis. The primary outcome was inpatient mortality and secondary outcomes are listed below.

Results: This study included 8,302 patients who had received a HSCT, of which 1070 (12.9%) were identified as black. Black recipients of a HSCT had a higher prevalence of obesity (8.6% versus 7.0%, p<0.001), hypertension (32.4% versus 23.7%, p<0.001), and chronic kidney disease (28.1% versus 21.3%, p<0.001), as well as a lower prevalence of smoking (17.1% versus 20.5%, p<0.001). Multivariate regression demonstrated that black recipients of a HSCT had higher inpatient mortality (OR 1.130, CI 1.087-1.174, p<0.001). On secondary analysis, black HSCT recipients were found to be more likely to have non-alcoholic fatty liver disease (OR 1.092, CI 1.039-1.147, p<0.001), thrombocytopenia (OR 1.133, CI 1.112-1.155, p<0.001), peripheral artery disease (OR 1.113, CI 1.067-1.161, p<0.001), hypertension (OR 1.215, CI 1.190-1.240, p<0.001), acute kidney failure (OR 1.162, CI 1.141-1.183, p<0.001), all-cause arrhythmias (OR 1.152, CI 1.120-1.186, p<0.001), all-cause shock (OR 1.173, CI 1.104-1.246, p<0.001), all-cause heart block (OR 1.089, CI 1.048-1.132, p<0.001), pericarditis (OR 1.186, CI 1.119-1.258, p<0.001), sepsis (OR 1.136, CI 1.119-1.153, p<0.001), hematuria (OR 1.128, CI 1.078-1.180, p<0.001), esophagitis (OR 1.138, CI 1.119-1.157, p<0.001), coagulopathies (OR 1.150, CI 1.108-1.193, p<0.001), chronic pulmonary disease (OR 1.120, CI 1.094-1.146, p<0.001), pulmonary hypertension (OR 1.178, CI 1.118-1.240, p<0.001), severe liver disease (OR 1.096, CI 1.061-1.132), acute heart failure (OR 1.188, CI 1.161-1.216, p<0.001), and myocardial infarction (OR 1.113, CI 1.081-1.147, p<0.001).

Conclusion: In this nationally-representative, population‐based retrospective cohort study, black patients who have received a HSCT and were subsequently hospitalized were associated with higher mortality and worse outcomes.

Disclosures

No relevant conflicts of interest to declare.

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2024
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