The impact of HIV and age on sociodemographic characteristics, inpatient metrics, and complications in Burkitt's lymphoma hospitalizations: A nationwide analysis (2016–2021).

Abstract

e19073 Background: Burkitt's lymphoma (BL) is an aggressive germinal center lymphoma with a worse prognosis in middle-aged and older adults. The sporadic and Human Immunodeficiency Virus (HIV)-associated-BL are the most common types seen in the US. With advances in the treatment of both HIV and BL, we aimed to study the effects of age and HIV status on inpatient hospitalizations. Methods: Patients diagnosed with BL between 2016 and 2021 were identified from the Nationwide Inpatient Sample (NIS) using ICD-10 codes. Age groups were categorized as "young" (≤40 years) and "old" (>40 years). The primary objective was to examine sociodemographic differences based on age groups and HIV status using descriptive statistics. Secondary objectives included analyzing differences and trends in hospitalization metrics, such as length of stay (LOS), total hospitalization charges (THC), inpatient complications, and mortality using linear and logistic regression. Results: There were 25,610 hospitalizations for BL, and the odds of hospitalization decreased by 3.6% annually between 2016 and 2021 (p<0.0001). Among them, 21% had a diagnosis of HIV, 66% of patients were older than 40 years, and 75% were male. The mean age was 50 years. The odds of HIV were 67% higher in younger patients, as well as among Black (67%) and Hispanic (32%) individuals (p<0.001). Additionally, Black patients were 52% more likely to belong to the younger age group. HIV-negative individuals had a higher proportion of hospitalizations with multiple sites (19.3% vs. 5.1%) or solid organ involvement (23.6% vs. 6.8%, p=0.0001). After adjusting for gender, race, insurance type, and hospital characteristics, neither HIV status nor age group significantly influenced LOS or THC. Inpatient complications like the need for ICU care, acute respiratory failure (ARF), sepsis, pneumonia, stroke, delirium, cardiac dysrhythmia, acute kidney injury (AKI), upper and lower gastrointestinal bleed (LGIB), tumor lysis syndrome (TLS), and deep vein thrombosis were more common in the older age group (p<0.05). HIV increases the odds of acute blood loss anemia, LGIB, AKI, cardiac arrest, and sepsis. While most complications declined or remained statistically unchanged, ARF and TLS showed an increasing trend from 2016-2020(p<0.05). The mortality rate among patients with BL was 3.5%, with older individuals having 1.8 times higher odds of death (p=0.01). However, HIV status did not significantly affect in-hospital mortality. Conclusions: Older age and HIV status significantly influenced presentation, inpatient complications, and mortality among BL hospitalizations, with older patients experiencing more severe outcomes. However, neither age nor HIV status impacted LOS or THC. These findings highlight that while clinical outcomes vary, these groups' financial burden remains consistent.