Acute lymphocytic leukemia severity and mortality hospitalizations in the United States: A population-based study

OBJECTIVES: The objective of the study was to understand the relationship between social and economic indicators of health and its association with hospitalization severity and mortality risk among ALL patients. METHODS: In this retrospective study, hospitalizations with primary and secondary diagnosis were identified using International Classification of Diseases (ICD 10) codes (C91.00, C91.01, C91.02) of ALL in the National Inpatient Sample (NIS) between 2016 and 2018. Hospitalization outcomes such as LOS, mortality, severity and mortality risk, cost, diagnosis (NDX), number of procedures (NPR) were analyzed by race and ethnicity, household income, and patient location among patients with primary and secondary ALL diagnoses. RESULTS: A total of 158090 hospitalizations were identified as meeting the inclusion criteria without missing cases with a primary or secondary diagnosis of ALL using ICD-10 codes. Severity risk at presentation varied from one area to the next, with the highest rate (per 10K) presentations in the New England region for both extreme likelihood (778) and extreme loss of function (2198) at presentation. Mortality and severity among uninsured patients were the second highest (614, 2193) compared to other payers. Extreme mortality risk at presentation was higher among African American (711), Caucasian (648), and Native American (612) populations compared to other racial and ethnic groups. CONCLUSION: The findings of this study suggest a relative decrease in presentation rate by year and higher mortality among specific groups-based demographics indicators. It also confirms the impact of advanced therapeutics and improved severity and mortality among younger populations with ALL compared to the older population.