Trends in Mortality and Comorbidity Burden in Myelodysplastic Syndrome Patients Across Racial Groups (2016,2019,2022)
Introduction/Background/Significance: Myelodysplastic syndrome (MDS) is characterized by abnormal blood cell production in the bone marrow. Although exact numbers may vary, approximately 10,000 new cases are diagnosed each year, with the condition being more common in older adults. In this study, we aimed to compare comorbidities, healthcare utilization including length of stay and total hospital charges, and in-hospital mortality rates across different racial groups with MDS diagnosis in 2016, 2019, and 2022.
Materials and Methods/Case Presentation/Objective: We used the 2016,2019, and 2022 National Inpatient Sample (NIS) database to identify all patients admitted with a primary diagnosis of Myelodysplastic syndrome (based on relevant ICD-10 codes), categorizing them by different racial groups to analyze their epidemiological differences, demographic characteristics, mortality rates, and associated healthcare burdens.
Results/Description/Main Outcome Measures: A total of 27,325 patients were included in the study, with 9,810 in 2016, 9,250 in 2019, and 8,265 in 2022. The mean age was 73.09 years, and 43.11% of the patients were female. The racial distribution consisted of 72.96% White, 9.46% Black, 8.75% Hispanic, and 8.84% categorized as Other, which includes Asian, Pacific Islander, and Native American individuals. In 2016, congestive heart failure was significantly more common among White patients (24.48%) and least common among Hispanic patients (15.34%) (p = 0.0406). In 2019, the highest prevalence of congestive heart failure was seen among Black patients (30.68%) (p = 0.0086). Chronic kidney disease was most prevalent among Black patients in 2022 (42.31%) (p = 0.0008). Diabetes mellitus was most common in Hispanic patients, affecting 42.67% in 2019 and 43.42% in 2022 (p = 0.0001 and p < 0.001, respectively). In 2019, folate deficiency was significantly more common in Black patients (1.14%) (p = 0.0179). Overall in-hospital mortality varied across the years, with 3.9% in 2016, 3.3% in 2019, and 4.23% in 2022 (p < 0.001). However, no significant differences in mortality were observed between racial groups in any single year. In 2016, the average length of stay was significantly longer among patients classified as Other, who stayed 2.61 days longer than White patients. No other significant differences in length of stay were observed in 2019 or 2022. Total hospital charges did not differ significantly among racial groups in any year. In 2016, sepsis was more frequently observed among patients classified as Other (8.81%) and Black patients (7.55%) compared to White (3.28%) and Hispanic (2.27%) patients (p = 0.0002).
Conclusions: In this nationally representative cohort of hospitalized patients with myelodysplastic syndromes, comorbidity patterns and mortality rates varied across racial groups and over time. While diabetes, chronic kidney disease, and heart failure were more prevalent in minority populations in specific years, in-hospital mortality did not significantly differ between racial groups. Sepsis appeared more frequently in Black and Other racial groups, particularly in earlier years of the study. These findings highlight the importance of ongoing efforts to address disparities in chronic disease burden and infection risk among patients with MDS.
