A new study examining hospitalization trends in patients with multiple myeloma (MM) during end-of-life care revealed a reduction in the percentage of patients dying in the hospital over time, but this rate was still high compared with the general population. Results were published in the journal BMC Cancer.

“Our study is the first to use a nationwide database to compare with publicly available mortality data to provide an estimate of the overall percentage of deaths from MM occurring in the hospital,” the study investigators wrote in their report.

The study was based on records of patients with MM identified from the US-based National Inpatient Sample. Patients included in this analysis had been discharged from hospitals between 2002 and 2017. The primary endpoint was the percentage of patients in this study who died in the hospital and changes in that percentage over time. Use of palliative care/hospice consultation and infection prevalence were secondary endpoints.


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A total of 1,446,809 hospitalizations occurred over the years analyzed, of which 85,816 ended in fatalities, equating to 6.3% of hospitalizations for patients with MM ending in death. Nearly half (47.4%) of the MM-related deaths in this study took place in the hospital setting. However, the rate of MM-related deaths that occurred in hospitals, as a percentage of total MM-related deaths, was 54% in 2002 and 41.4% in 2017 (P <.01).

Approximately one-third (32.7%) of patients who died during hospitalization were given blood transfusions while hospitalized. Infections were found in nearly half (47.8%) of the patients who died during hospitalization.

Use of palliative care/hospice services was seen with 5.3% of hospitalizations that led to death in 2002, and this rate rose to 31.44% in 2017 (P <.01). The study investigators additionally evaluated inflation-adjusted costs associated with hospitalizations leading to death. In 2002, the median cost was $62,202, and it rose to $150,451 in 2017 (P <.001).

“Our study shows that despite advances in MM therapy and supportive care, greater than 40% of patients with MM continue to die in the hospital as of 2017, although there has been a reassuring decrease since 2002,” the study investigators stated in their report. They also noted that the US general population also showed a decrease in in-hospital deaths from all causes over a similar time span.

Disclosure: Several study authors declared affiliations with the biotech or pharmaceutical industries. Please see the original reference for a full list of authors’ disclosures.

Reference

Abbasi S, Roller J, Abdallah AO, et al. Hospitalization at the end of life in patients with multiple myeloma. BMC Cancer. 2021;21(1):339. doi:10.1186/s12885-021-08079-x