Department of Dermatology, Case Western Reserve University School of Medicine.
Department of Dermatology, University Hospitals Cleveland Medical Center.
Am J Clin Oncol. 2019 Nov;42(11):830-836. doi: 10.1097/COC.0000000000000605.
Although adolescents and young adults (AYA) suffer disproportionately from cutaneous melanoma (CM), little is known regarding the burden of CM leading to hospitalization in AYA. The objective of this study was to elucidate sociodemographic/hospitalization characteristics of AYA CM inpatients, determine which factors lead to the greater length of stay (LOS) and cost of care for AYA CM inpatients, and evaluate trends in the prevalence, LOS, and cost of care for AYA CM hospitalizations.
A retrospective cohort study of nationally representative data from the 2009 to 2015 National Inpatient Sample. Multivariable survey-weighted logistic regression models were used to determine sociodemographic factors associated with AYA CM hospitalization. Multivariable survey-weighted linear regression models were used to determine characteristics associated with the greater cost of care and LOS in AYA CM inpatients.
A total of 8986 AYA CM inpatients were included in this study. The prevalence of AYA CM hospitalizations is decreasing over time while the cost of care is increasing. On average, AYA CM hospitalizations were 3.3 days long and cost $38,018.40. Controlling for all covariates, male sex, older age, non-Hispanic white race, higher income, private insurance, and elective admissions were associated with AYA hospitalization due to CM (P<0.0001). Male sex was associated with longer LOS (P=0.007) and cost of care (P=0.01) among AYA hospitalized for CM.
Despite a decreasing prevalence of CM hospitalizations in AYA inpatients, the economic burden of these hospitalizations is increasing. Substantial sex-based differences exist in the inpatient burden of AYA CM. Further research is required to elucidate the causes of these differences and prevent AYA hospitalization due to CM.
尽管青少年和年轻人（AYA）不成比例地患有皮肤黑色素瘤（CM），但对于导致 AYA 住院的 CM 负担知之甚少。本研究的目的是阐明 AYA 黑素瘤住院患者的社会人口统计学/住院特征，确定哪些因素导致 AYA 黑素瘤住院患者的住院时间（LOS）和医疗费用增加，并评估 AYA 黑素瘤住院患者的患病率、LOS 和医疗费用的趋势。
这是一项使用 2009 年至 2015 年全国住院患者样本的全国代表性数据进行的回顾性队列研究。使用多变量调查加权逻辑回归模型确定与 AYA CM 住院相关的社会人口统计学因素。使用多变量调查加权线性回归模型确定与 AYA CM 住院患者更高的医疗费用和 LOS 相关的特征。
本研究共纳入 8986 例 AYA CM 住院患者。AYA CM 住院的患病率随着时间的推移呈下降趋势，而医疗费用却在增加。平均而言，AYA CM 住院时间为 3.3 天，费用为 38018.40 美元。在控制所有协变量的情况下，男性、年龄较大、非西班牙裔白人、较高收入、私人保险和择期入院与 AYA 因 CM 住院有关（P<0.0001）。男性与 AYA 因 CM 住院的 LOS 延长（P=0.007）和医疗费用增加（P=0.01）相关。
尽管 AYA 住院患者中 CM 住院的患病率呈下降趋势，但这些住院的经济负担却在增加。AYA 黑素瘤住院患者的住院负担存在显著的性别差异。需要进一步研究以阐明这些差异的原因，并预防因 CM 导致的 AYA 住院。
