Impact of hospital variation in hematologic malignancy patient proportions on outcomes of chronic lymphocytic leukemia patients undergoing cardiac surgery: insights from nationwide data analysis.

OBJECTIVE

This study aimed to investigate the impact of the proportion of hematologic malignancy patients in hospitals on the prognosis of chronic lymphocytic leukemia (CLL) patients undergoing cardiac surgery. Perioperative management of CLL patients is complex, particularly regarding immunosuppression and infection risks.

METHODS

This retrospective study utilized data from the National Inpatient Sample (NIS) from 2010 to 2021. Adult CLL patients undergoing cardiac surgery were included, categorizing hospitals into five quintiles based on hematologic malignancy patient proportions. Outcomes included in-hospital mortality, acute kidney injury (AKI), postoperative bleeding, and infections.

RESULTS

AKI incidence was significantly lower in the Q5 group (OR: 0.68, 95% CI: 0.49-0.97), as was the rate of respiratory failure (OR: 0.53, 95% CI: 0.35-0.79). However, the rates of transfusion and acute heart failure were significantly higher in Q5 (acute heart failure OR: 1.70, 95% CI: 1.07-2.77). No significant differences were found in in-hospital mortality or other complications.

CONCLUSION

The proportion of hematologic malignancy patients affects CLL patient outcomes, with higher proportions linked to lower AKI and respiratory failure rates but increased transfusion and heart failure risks. Further research is warranted.