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Application of big data analyses to compare the impact of oral and gastrointestinal mucositis on risks and outcomes of febrile neutropenia and septicemia among patients hospitalized for the treatment of leukemia or multiple myeloma

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Abstract

Purpose

Oral ulcerative mucositis (UM) and gastrointestinal mucositis (GIM) have been associated with increased likelihood of systemic infection (bacteremia and sepsis) in patients being treated for hematological malignancies. To better define and contrast differences between UM and GIM, we utilized the United States 2017 National Inpatient Sample and analyzed patients hospitalized for the treatment of multiple myeloma (MM) or leukemia.

Methods

We utilized generalized linear models to assess the association between adverse events—UM and GIM—among hospitalized MM or leukemia patients and the outcome of febrile neutropenia (FN), septicemia, burden of illness, and mortality.

Results

Of 71,780 hospitalized leukemia patients, 1255 had UM and 100 GIM. Of 113,915 MM patients, 1065 manifested UM and 230 had GIM. In an adjusted analysis, UM was significantly associated with increased risk of FN in both the leukemia (aOR = 2.87, 95% CI = 2.09–3.92) and MM cohorts (aOR = 4.96, 95% CI = 3.22–7.66). Contrastingly, UM had no effect on the risk of septicemia in either group. Likewise, GIM significantly increased the odds of FN in both leukemia (aOR = 2.81, 95% CI = 1.35–5.88) and MM (aOR = 3.75, 95% CI = 1.51–9.31) patients. Similar findings were noted when we restricted our analysis to recipients of high-dose condition regimens in preparation for hematopoietic stem-cell transplant. UM and GIM were consistently associated with higher burden of illness in all the cohorts.

Conclusion

This first use of big data provided an effective platform to assess the risks, outcomes, and cost of care of cancer treatment-related toxicities in patients hospitalized for the management of hematologic malignancies.

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Data availability

We used data from the United States’ 2017 National Inpatient Sample database obtained from Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality (AHRQ).

Code availability

Not applicable.

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Author information

Authors and Affiliations

  1. University at Buffalo, Buffalo, NY, 14203, USA

    Poolakkad S. Satheeshkumar

  2. Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands

    Nicole Blijlevens

  3. Dana Faber Cancer Institute, Boston, MA, USA

    Stephen T. Sonis

  4. Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA

    Stephen T. Sonis

  5. Primary Endpoint Solutions, Waltham, MA, USA

    Stephen T. Sonis

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  1. Poolakkad S. Satheeshkumar
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Contributions

S. K. contributed to the design, conception, acquisition, interpretation of the data, drafting, and critical revision of the manuscript; S. S. contributed to the design, conception, acquisition, interpretation of the data, drafting, and critical revision of the manuscript; and N. B. contributed to the design and critical revision of the manuscript.

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Correspondence to Poolakkad S. Satheeshkumar.

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Satheeshkumar, P.S., Blijlevens, N. & Sonis, S.T. Application of big data analyses to compare the impact of oral and gastrointestinal mucositis on risks and outcomes of febrile neutropenia and septicemia among patients hospitalized for the treatment of leukemia or multiple myeloma. Support Care Cancer 31, 199 (2023). https://doi.org/10.1007/s00520-023-07654-1

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