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CC BY 4.0 · TH Open 2019; 03(03): e203-e209
DOI: 10.1055/s-0039-1692988
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Trends and Inpatient Outcomes of Venous Thromboembolism-Related Admissions in Patients with Philadelphia-Negative Myeloproliferative Neoplasms

Vatsala Katiyar 
1   Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States
,
Alok Uprety
1   Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States
,
Andres Mendez-Hernandez
1   Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States
,
Harry E. Fuentes 
2   Department of Hematology and Oncology, Mayo Clinic, Rochester, Minnesota, United States
,
Xavier A. Andrade
1   Department of Medicine, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States
,
Maryam Zia
3   Department of Hematology and Oncology, John H. Stroger Jr. Hospital of Cook County, Chicago, Illinois, United States
› Author Affiliations
Further Information

Publication History

31 December 2018

17 May 2019

Publication Date:
17 July 2019 (online)

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Abstract

Background Patients with Philadelphia-negative myeloproliferative neoplasms (MPNs), including polycythemia vera (PV), essential thrombocytosis (ET), and primary myelofibrosis (MF), have a significant risk of venous thromboembolism (VTE). We aim to determine the trends in annual rates of VTE-related admissions, associated cost, length of stay (LOS), and in-hospital mortality in patients with MPN.

Methods We identified patients with PV, ET, and MF from the Nationwide Inpatient Sample (NIS) database from 2006 to 2014 using ICD-9CM coding. Hospitalizations where VTE was among the top-three diagnoses were considered VTE-related. We compared in-hospital outcomes between VTE and non-VTE hospitalizations using chi-square and Mann–Whitney U-test and used linear regression for trend analysis.

Results We identified 1,046,666 admissions with a diagnosis of MPN. Patients were predominantly white (65.6%), females (52.7%), with a median age of 66 years (range: 18–108). The predominant MPN was ET (54%). There was no difference in in-hospital mortality between groups (VTE: 3.4% vs. non-VTE: 3.2%; p = 0.12); however, VTE admissions had a longer LOS (median: 6 vs. 5 days; p < 0.01) and higher cost (median: VTE US$32,239 vs. 28,403; p ≤ 0.01).

The annual rate of VTE admissions decreased over time (2006: 3.94% vs. 2014: 2.43%; p ≤ 0.01), compared with non-VTE–related admissions.

Conclusion In our study, VTE-related admissions had similar in-hospital mortality as compared with non-VTE–related admissions. The rates of hospitalizations due to VTE have decreased over time but are associated with a higher cost and LOS. Newer risk assessment tools may assist in preventing VTE in high-risk patients and optimizing resource utilization.

Keywords

venous thromboembolism - myeloproliferative neoplasm - polycythemia vera - essential thrombocytosis - primary myelofibrosis
 

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