Inpatient Healthcare Resource Utilization, Costs, and Mortality in Adult Patients with Acute Graft-versus-Host Disease, Including Steroid-Refractory or High-Risk Disease, following Allogeneic Hematopoietic Cell Transplantation: HCRU, Costs, and Mortality Associated with Acute GVHD

Jingbo Yu, Jennifer T. Judy, Shreekant Parasuraman, Meenal Sinha, Daniel Weisdorf

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Abstract

Acute graft-versus-host disease (GVHD) contributes to poor outcomes following allogeneic hematopoietic cell transplantation (HCT). Data are limited regarding the economic burden of acute GVHD, particularly steroid-refractory or high-risk (SR/HR) disease. This retrospective analysis of the Premier Healthcare Database reports inpatient healthcare resource utilization (HCRU), costs, and mortality during initial hospitalization for allogeneic HCT and through 100 days post-HCT among patients who developed acute GVHD, including a subgroup with SR/HR disease, compared with patients without GVHD. The analysis included adults discharged for first HCT between January 1, 2011, and June 30, 2016 (acute GVHD, n = 906; SR/HR acute GVHD, n = 158; no GVHD, n = 1529). During the initial hospitalization for HCT, patients with acute GVHD and SR/HR acute GVHD (n = 455 and 125, respectively) had significantly longer median lengths of stay (31 and 46 days versus 24 days) and higher median total costs ($153,849 and $205,880 versus $97,417) versus patients with no GVHD (n = 1529; P <. 0001 for all). During the 100-day post-HCT period, patients with acute GVHD and SR/HR acute GVHD had higher readmission rates (78.3% and 77.2% versus 28.3%; P <. 0001) and inpatient mortality rates (20.2% and 35.4% versus 8.9%; P <. 0001) versus patients with no GVHD. In summary, acute GVHD, especially SR/HR disease, is associated with longer inpatient stays, higher readmission rates, and higher inpatient mortality compared with no GVHD.

Original languageEnglish (US)
Pages (from-to)600-605
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number3
DOIs
StatePublished - Mar 2020

Bibliographical note

Funding Information:
Financial disclosure: Writing assistance was provided by Tania Iqbal, PhD (Complete Healthcare Communications, North Wales, PA), a CHC Group Company, and was funded by Incyte Corporation. Conflict of interest statement: J.Y. and S.P. are employees and stockholders of Incyte Corporation. J.J. and M.S. are employees of Premier, Inc. D.W. has received research support from Incyte Corporation and support as a consultant from Pharmacyclics and FATE.

Funding Information:
Financial disclosure: Writing assistance was provided by Tania Iqbal, PhD (Complete Healthcare Communications, North Wales, PA), a CHC Group Company, and was funded by Incyte Corporation. Conflict of interest statement: J.Y. and S.P. are employees and stockholders of Incyte Corporation. J.J. and M.S. are employees of Premier, Inc. D.W. has received research support from Incyte Corporation and support as a consultant from Pharmacyclics and FATE. Financial disclosure: See Acknowledgments on page 605.

Publisher Copyright:
© 2019 American Society for Transplantation and Cellular Therapy

Keywords

  • Acute graft-versus-host disease
  • Allogeneic hematopoietic cell transplantation
  • Inpatient healthcare resource utilization
  • Inpatient mortality
  • Steroid refractory
  • Total costs

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