International Internal Medicine Journal(IIMJ)
ISSN: 2837-4835 | DOI: 10.33140/IIMJ
Impact Factor: 1.02
Insights into Readmission Trends Following Inpatient Chemotherapy for Acute Lymphoblastic Leukemia: A 30-Day Analysis
Abstract
Silpa Choday, Diana Zamora, Anthony Yeung and Miguel Gonzalez
Introduction: Acute lymphoblastic leukemia (ALL) has significant morbidity due to its aggressive course and intensive treatment protocols. Understanding the patterns of readmission after inpatient chemotherapy is crucial for optimizing patient care and resource allocation.
Methods: We conducted a retrospective analysis of the National Readmission Database among ALL patients who underwent inpatient chemotherapy between 2016 and 2020. We examined trends in 30-day readmission rates, factors associated with readmission, and outcomes such as remission and relapse.
Results: A total of 22,483 admissions were analyzed. Of these, 72.5% (16,294) experienced readmission. Notably, the trend in readmission rates declined between 2016 to 2020, dropping from 76.1% to 66.3%. Among the 16,294 readmissions, 3,607 achieved remissions, 10,637 has stable disease and 2,051 had relapsed disease (P<.001). The mean age at remission was at 18.9 years, while non-remission and relapse occurred at older ages (32.2 and 31 years, respectively, P<.001). In terms of insurance, private insurance had the highest readmission rate at 48%, followed by Medicaid at 35%, and Medicare at 12% (P<.001). The odds ratios indicated significant differences: Elective readmissions had a significantly higher risk compared to non-elective readmissions (4.01, 95% CI 3.44 - 4.67, P<.001), Additionally, patients achieving remission had a lower risk of readmission compared to those not achieving remission (0.52, 95% CI 0.42 - 0.64, P=.003), and. relapse (0.52, 95% CI 0.42 - 0.64, P<.001).
Conclusion: Our study highlights factors such as relapsed disease, insurance status, elective admissions, and age were associated with higher readmission risk. These findings emphasize the importance of targeted interventions to reduce the rates of readmission and improve outcomes in ALL patients.