Burden of hospital readmissions for venous thromboembolism among patients with cancer

ASH: 60th American Society of Hematology Annual Meeting & ExpositionAJ Amin, S Deitelzweig, J Lin, M Lingohr-Smith, B Menges, WR Neuman | December 02, 2018

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Summary: In this retrospective, real-world study, researchers assessed the frequency and associated costs of hospital readmission related to venous thromboembolism (VTE) in patients with cancer throughout the United States.  They concluded that a large number of patients who had been hospitalized for cancer experienced a VTE that required re-hospitalization, with almost 30% readmitted within 30 days of post-discharge. Further, they found that the total costs of readmissions were substantial, as high as $41K for resubmissions due to primary diagnosis of DVT/PE.

Methods:

  • Using the MarketScan databases from July 1, 2011 to March 31, 2015, researchers identified patients hospitalized for acute medical illness, including cancer, based on the primary hospital discharge diagnosis codes.
  • They included patients aged ≥ 40 years who had continuous insurance enrollment in the 6 months prior to initial (index) hospitalizations (baseline period) and in the 6 months after hospital discharge (follow-up period).
  • Study endpoints included the proportion of patients with VTE as either the primary or any position (VTE-related) of discharge diagnosis codes among hospital readmissions during the follow-up period, and the associated costs for VTE-related or primary VTE readmissions.

Results:

  • Of the total population 12,785 acute medically ill patients (mean age: 68.3 years; 51.6% female), 15.7% (n=2,002) were hospitalized for cancer (mean age: 63.4 years; 62% were < 65 years; 49.1% female).
  • Among patients with cancer, 3.9% had a VTE-related hospital readmission in the 6 months following hospital discharge, and 51.3% were for a primary diagnosis of VTE.
  • Researchers found the highest frequency of readmissions in patients with cancer were the highest among all medical illnesses they investigated, including acute heart failure, infectious diseases, ischemic stroke, respiratory diseases, and rheumatic diseases).
  • In all, 28.2% of the VTE-related hospital readmissions occurred within the first 30 days of post-discharge, with a mean length of hospital stay (LOS) of 7.6 days, and mean total cost of $35,012.
  • For primary VTE readmissions, mean LOS was 5.2 days and mean total cost was $19,961; for readmissions with a primary diagnosis of DVT, PE, and DVT/PE, mean total costs were $12,968, $13,029, and $41,574, respectively.

This study was sponsored by Portola Pharmaceuticals.

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