Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California , Los Angeles , CA , USA.
Keck School of Medicine, University of Southern California , Los Angeles , CA , USA.
Leuk Lymphoma. 2019 Oct;60(10):2464-2470. doi: 10.1080/10428194.2019.1581932. Epub 2019 Mar 8.
While the initial hospitalization accounts for 75% of total healthcare costs during the first 100 days following hematopoietic stem cell transplantation (HSCT), there is a lack of studies evaluating the considerable variation in cost estimates. Using the National Inpatient Sample (NIS) database from 2012-2014, we identified 1832 adult non-Hodgkin lymphoma (NHL) patients who received autologous or allogeneic HSCT and examined complications as predictors of hospital cost. Complications occurred in >70% of patients, and the presence of one or more complications was associated with an increase in mean hospital costs of 46% in autologous HSCT and 81% in allogeneic HSCT. The most common complications (∼40%) were mucositis, febrile neutropenia, and infection. Acute organ failure, acute graft-versus-host disease, and death were less frequent (∼10%) but had a greater impact on increasing hospital costs and length of stays. Despite recent advances in supportive care and pre-conditioning regimens, complications are common and costly during HSCT.
尽管造血干细胞移植（HSCT）后 100 天内的最初住院费用占总医疗费用的 75%，但目前缺乏评估成本估计值存在较大差异的研究。本研究利用 2012-2014 年国家住院患者样本数据库（NIS），共纳入 1832 例接受自体或异基因 HSCT 的成人非霍奇金淋巴瘤（NHL）患者，分析并发症作为住院费用的预测因素。>70%的患者发生并发症，且 1 种或多种并发症的存在使自体 HSCT 和异基因 HSCT 的平均住院费用分别增加 46%和 81%。最常见的并发症（约 40%）是黏膜炎、发热性中性粒细胞减少症和感染。急性器官衰竭、急性移植物抗宿主病和死亡的发生率较低（约 10%），但对增加住院费用和住院时间的影响更大。尽管在支持性护理和预处理方案方面取得了最近的进展，但并发症在 HSCT 期间仍然很常见且代价高昂。
