Exploring the Impact of Race and Comorbidities on AML Hospital Outcomes

Introduction/Background/Significance: American cancer society is estimating 22, 000 new diagnosis of Acute Myeloid Leukemia (AML) and half of that diagnosis will die from AML. AML accounts for 1 out of 3 leukemias in adults. This study aims to investigate comorbidity prevalences, health care utilizations and mortality rates across different racial groups with AML diagnosis in 2016, 2019, 2022.

Materials and Methods/Case Presentation/Objective: We used the 2016,2019,2022 National Inpatient Sample (NIS) database to identify all patients admitted with a primary diagnosis of AML (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 63,320 patients were included in the study, with 55.73% identifying as male. The distribution of patients across the study years was 19,575 in 2016, 21,775 in 2019, and 21,970 in 2022. The overall mean age was 59.81 years, with year-specific means of 59.05, 60.22, and 60.08, respectively. White patients comprised 67.63% of the cohort, followed by Black (9.98%), Hispanic (10.06%), and Other racial groups—including Asian, Pacific Islander, Native American, and others—at 12.33%. Cerebrovascular accident (CVA) was most prevalent among Black patients (2.22%) and least common in Hispanic patients (1.02%) (p = 0.0054). Congestive heart failure (CHF) was most frequently observed in White patients (13.67%) and least in Hispanic patients (7.54%) (p < 0.001). Sepsis occurred most commonly in patients categorized as Other (14.47%) and least among White patients (13.53%). Chronic kidney disease (CKD) was more prevalent in Black patients (15.74%) and least in Hispanic patients (9.03%) (p < 0.001). Diabetes mellitus (DM) was highest in Black patients (25%) and lowest in White patients (18.51%) (p< 0.001). Bone marrow transplantation was most frequently performed in the Other racial group (5.15%) and least in White patients (3.61%). In-hospital mortality significantly declined over time, from 11.51% in 2016 to 9.7% in 2019 and 9.6% in 2022. However, mortality differences among racial groups were not statistically significant. Hispanic patients had a significantly longer mean length of stay (+4.2 days, p < 0.001) and higher total hospital charges (+$124,714, p < 0.001) compared to White patients.

Conclusions: This study highlights significant racial disparities in comorbidities, healthcare utilization, and outcomes among hospitalized patients. Black patients had higher rates of CVA, CKD, and diabetes, while Hispanic patients experienced longer hospital stays and higher total charges despite having lower rates of several comorbidities. Although in-hospital mortality differed across study years, no significant differences were observed between racial groups. These findings underscore the need for targeted interventions to improve equity in cancer-related care delivery.