In-hospital outcomes of sepsis in patients with diffuse large B-cell lymphoma: Insights from National Inpatient Sample.

Abstract

e19077 Background: Per the Sepsis-3 guidelines published in 2016, sepsis was defined as a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Patients with Diffuse Large B-Cell Lymphomas (DLBCL) are at increased risks for developing sepsis. In this retrospective cohort study, we sought to identify the in-hospital outcomes of patients with DLBCL admitted for sepsis. Methods: Using the National inpatient sample (NIS) database from 2018-2021, we retrospectively analyzed patients admitted with a primary diagnosis of sepsis using the appropriate ICD10 code. Our primary population included patients ≥ 18 years admitted for sepsis. Patients were divided into 2 groups either having a DLBCL or not. Using a univariate and multivariate analysis, we compared the odds of various in hospital outcomes. The primary outcome was in-hospital mortality. Secondary outcomes considered were need for vasopressors, rate of mechanical ventilation (MV), need for renal replacement therapy (RRT), Disseminated intravascular coagulation (DIC), acute kidney injury (AKI), length of stay (LOS) and total charges (TOTCHG). Results: There were 9,004,557 admissions for Sepsis out of which 33,400 (0.37%) had DLBCL. Compared to non DLBCL group, there was significantly higher odds of in-hospital mortality (adjusted odds ratio (aOR): 1.48, CI: 1.38-1.59, p <0.001). Regarding secondary outcomes, there was increased odds of DIC (aOR: 1.81, CI: 1.48-2.1, p <0.001), need for vasopressor support (aOR: 1.45, CI: 1.32-1.59, p <0.001), LOS (+0.7 days, CI: 0.47-0.92, p <0.001) and additional TOTCHG (+ $17725.61 in additional costs, CI: $12855 - $22595, p <0.001). There was statistically no difference in AKI (aOR: 1.05, CI: 0.972-1.15, p-value 0.192) both groups however, DLBCL patients had significantly lower outcomes of requiring MV (aOR: 0.87, CI: 0.81-0.93, p <0.001) and needing RRT (aOR: 0.65, CI: 0.58-0.74, p <0.001) when compared to non DLBCL cohort. Conclusions: Patients with DLBCL have an overall increased risk of mortality when admitted for sepsis, with notably worse outcomes, increased length of stay and increased healthcare utilization costs. Further research may be needed to explain these outcomes in this patient population.