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Blood Clots in MPN Related to Higher Cost, Length of Stay for Patients With MPN

AJMC Staff
Blood clots, or venous thromboembolism, remains a leading causes of death and healthcare spending in patients with cancer.
A recently published study aimed to determine the trends in annual rates of hospital admissions related to venous thromboembolism (VTE), as well as the associated cost, length of stay (LOS), and in-hospital mortality in patients with Philadelphia-negative myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocytosis (ET), and primary myelofibrosis (MF).

These patients have a significant risk of VTE, said researchers. Up to one-third of patients with MPN develop VTE, and this has led to development of recommendations of risk-adapted strategies to decrease the thromboembolism rate. However, VTE remains a leading causes of death and healthcare spending in patients with cancer.

In this study, researchers identified patients with PV, ET, and MF from the Nationwide Inpatient Sample (NIS) database from 2006 to 2014.

Hospitalizations where VTE was among the top-3 diagnoses were considered VTE-related. In-hospital outcomes between VTE and non-VTE hospitalizations were compared using chi-square and Mann-Whitney U-test; linear regression was used for trend analysis. 

The authors identified 1,046,666 admissions with a diagnosis of MPN. The majority of patients were white (65.6%) and female (52.7%), with a median age of 66 years. ET was the most common MPN (54%).

There was no difference in in-hospital mortality between groups (VTE: 3.4% vs. non-VTE: 3.2%; P  = .12); however, VTE admissions had a longer LOS (median: 6 vs. 5 days; < .01) and higher cost (median: VTE $32,239 vs. $28,403; ≤ .01).

The annual rate of VTE admissions decreased over time (2006: 3.94% vs. 2014: 2.43%; ≤.01), compared with non-VTE-related admissions. 

Researchers found that VTE-related admissions had similar in-hospital mortality as compared with non-VTE-related admissions. Hospitalization rates due to VTE have decreased over time but are linked to higher cost and LOS. Newer risk assessment tools may assist in preventing VTE in high-risk patients and optimizing resource utilization.

Reference

Katiyar V, Uprety A, Mendez-Hernandez A, Fuentes HE, Andrade XA, Zia M. Trends and inpatient outcomes of venous thromboembolism-related admissions in patients with Philadelphia-negative myeloproliferative neoplasms [published July 17, 2019]. doi: 10.1055/s-0039-1692988

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