In-hospital mortality of hematopoietic stem cell transplantation among children with nonmalignancies: A nationwide study in the United States from 2000 to 2012

Takuto Takahashi, Maria A. Pereda, Natasha Bala, Sairaman Nagarajan

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7 Scopus citations

Abstract

BACKGROUND: Hematopoietic stem cell transplant (HSCT) can cure or alleviate a wide range of nonmalignant childhood conditions. However, few studies have examined longitudinal national trends of frequency or short-term complications of HSCT before 2006 when an HSCT became a reportable procedure by US law. By using a US nationally representative database, we conducted nationwide longitudinal analyses on demographics, in-hospital mortality, and short-term complications in nonmalignant HSCT from 2000 to 2012.

PROCEDURE: We analyzed 2504 admissions for children < 20 years old who underwent an allogeneic HSCT for a nonmalignant condition by using the Kids' Inpatient Database for the years 2000, 2003, 2006, 2009, and 2012. Changes in in-hospital mortality and other outcomes were assessed over the study period using weighted analyses, which enabled generation of national estimates in each year.

RESULTS: The number of admissions for HSCT increased from 334 to 667 from 2000 to 2012, respectively; among them, the use of bone marrow decreased (66.5% to 34.1%, P < 0.001). In-hospital mortality declined (13.4% to 7.1%, P = 0.04), as did bacteremia (28.7% to 10.1%, P < 0.001) and vascular catheter infections (18.8% to 8.7%, P = 0.006), but cytomegalovirus infections increased (4.9% to 15.9%, P < 0.001), as did adenovirus infections (1.8% to 6.9%, P < 0.001) from 2000 to 2012.

CONCLUSION: Population-based analyses demonstrated a substantial expansion of the utilization of HSCT occurred for pediatric nonmalignancies from 2000 to 2012 in the United States, whereas the in-hospital mortality declined by approximately a half. Further research is needed to identify distinct contributing factors.

Original languageEnglish (US)
Article numbere27626
JournalPediatric Blood and Cancer
Volume66
Issue number6
DOIs
StatePublished - Jun 2019

Bibliographical note

Publisher Copyright:
© 2019 Wiley Periodicals, Inc.

Keywords

  • in-hospital mortality
  • kids’ inpatient database
  • nonmalignant
  • posttransplant complication
  • stem cell transplantation
  • Prognosis
  • Follow-Up Studies
  • Humans
  • Child, Preschool
  • Infant
  • Male
  • Transplantation, Autologous
  • Hospital Mortality/trends
  • Young Adult
  • Adult
  • Female
  • Hospitalization/statistics & numerical data
  • Retrospective Studies
  • Child
  • Infant, Newborn
  • Databases, Factual
  • Risk Factors
  • Survival Rate
  • Adolescent
  • Hematologic Diseases/mortality
  • Hematopoietic Stem Cell Transplantation/mortality
  • Longitudinal Studies

PubMed: MeSH publication types

  • Journal Article

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