Advertisement

ND2 BURDEN OF HOSPITALIZATIONS IN HEREDITARY TRANSTHYRETIN AMYLOIDOSIS (HATTR) WITH AND WITHOUT HEMATOPOIETIC STEM CELL TRANSPLANT: A PROPENSITY SCORE MATCHED ANALYSIS OF IN-PATIENT CLAIMS DATABASE

      Objectives

      To examine trends in hospital length of stay and total costs in hATTR patients with and without Hematopoietic Stem Cell Transplant (HSCT).

      Methods

      The latest available 2016 National Inpatient Sample (NIS) data set from the Healthcare Cost and Utilization Project was utilized in order to determine the number of hospital admissions for patients with NHL. Propensity score matched analysis was conducted to compare hospital LOS and costs in hATTR patients with and without HSCT. Thirty comorbidities were assessed using Elixhauser scoring. Multivariate logistic regression was conducted to assess predictor variables for LOS and costs.

      Results

      In 2016, there were an estimated 23,335 hospitalizations with a diagnosis of hATTR, of which 260 also had a procedure code for HSCT. The mean age was 60.6 (SD 8.4) and 70.3 (SD 13.8) in hATTR patients with and without HSCT, respectively. 46.1% and 43.3% were female in hATTR with and without HSCT, respectively. Most common comorbidities (more than 20%) were congestive heart failure (46.1%), cardiac arrhythmias (40.4%), uncomplicated hypertension (38.2%), complicated hypertension and renal failure (44.7%). The propensity score matched hospital LOS was 19.1 and 6.4, with a statistically significant difference of 12.6 days (SE 1.61, P<0.05), in hATTR patients with and without HSCT. The propensity score matched hospital charges were $255,968 and $69,640, with a statistically significant difference of $186,327 (SE $30668 P<0.05), in hATTR patients with and without HSCT. Predictor variables for hospital LOS and costs were HSCT, cardiac arrhythmias and coagulopathy.

      Conclusions

      hATTR patients with HSCT incur significantly longer hospital length of stay and nearly 4 times the costs compared to patients without HSCT. There is a need for better treatment management for patients with hATTR undergoing HSCT.