Diffuse large B-cell lymphoma: examining evolving patterns in mortality, incidence, and demographics.

in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico by Silpa Choday, Eric Tran, Miguel Gonzalez

TLDR

  • The study analyzed trends in diffuse large B-cell lymphoma (DLBCL) hospitalization, inpatient mortality, and costs from 2016 to 2020, identifying increasing hospitalizations, decreasing inpatient mortality rates, and increasing hospital charges.

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma, characterized by its aggressive nature and heterogeneity. This study analyzes recent trends in DLBCL including trends in hospitalization, inpatient mortality, and costs. Using the Nationwide Inpatient Sample (NIS) database from 2016 until 2020, a retrospective cohort study was performed to identify DLBCL hospitalization, discharges, and investigate outcomes. Trends were adjusted for age, sex, race, insurance type, mean household income, and hospital characteristics. Multivariable logistic regression has been used to analyze the data. A total of 103,588,729 records were analyzed, identifying 47,425 cases with a diagnosis of DLBCL. From 2016 to 2020, hospitalizations have increased from 14,980 to 16,565. The mean age at diagnosis was 65 (P < 0.001). Males were slightly more affected than females (57.3 vs 42.6), with an increasing trend in males from 53.7% to 62.3% (P = 0.03). The highest prevalence was observed in the White population, followed by Hispanics and African Americans. Notably, the prevalence among Hispanics increased from 10 to 12%, while there is a decreasing trend in other demographics (P = 0.05). Medicare was the most common insurance, with increasing trends, followed by Medicaid and private insurance (P = 0.6). Inpatient mortality increased from 6.1 to 7.1 (2016 to 2018) and decreased to 6.1% (2018 to 2020) (P < 0.001). The mean length of the stay remained stable at 11.8 days. However, hospital charges increased from $176,131 to $212,324. Comorbidities such as obesity, hypertension, other associated lymphomas, peripheral vascular diseases, and diabetes showed an increasing trend (P < 0.05). Discharges to home and skilled nursing facility (SNF) decreased, while there was an increase in discharges to home with home health (HH) care and short-term care (P < 0.001). Risk factors for DLBCL include white male sex, with the mean age of 65 years. The incidence among the Hispanic population has been increasing over the years. There are disparities in incidence and survival among different ethnic/demographic groups that need to be addressed by identifying targeted interventions and equitable healthcare access.

Overview

  • This study analyzed recent trends in diffuse large B-cell lymphoma (DLBCL) using the Nationwide Inpatient Sample (NIS) database from 2016 to 2020.
  • The study identified 47,425 cases with a diagnosis of DLBCL and analyzed trends in hospitalization, inpatient mortality, and costs.
  • The primary objective of the study was to investigate the trends in DLBCL hospitalization, discharges, and outcomes, and to identify risk factors and disparities in incidence and survival.

Comparative Analysis & Findings

  • The study found that hospitalizations for DLBCL increased from 14,980 to 16,565 from 2016 to 2020.
  • The mean age at diagnosis was 65 years, and males were slightly more affected than females, with an increasing trend in males from 53.7% to 62.3%.
  • Inpatient mortality rates increased from 6.1 to 7.1% from 2016 to 2018, and then decreased to 6.1% from 2018 to 2020. Hospital charges increased significantly during the study period.

Implications and Future Directions

  • The study highlights the importance of identifying targeted interventions and equitable healthcare access to address disparities in incidence and survival among different ethnic/demographic groups.
  • Future research should focus on identifying the efficacy of these interventions and developing culturally sensitive healthcare strategies to improve outcomes for DLBCL patients.
  • Additionally, studying the impact of socioeconomic factors, such as insurance type and household income, on disease outcomes and hospitalization costs will be essential for informing healthcare policy and resource allocation.
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