Patterns and Predictors of 90-Day Readmission in Hodgkin Lymphoma: A Nationwide Analysis Using the 2022 Nationwide Readmission Database

Introduction/Background/Significance: Hodgkin lymphoma, though rare, continues to carry a high mortality rate. Despite favorable five-year survival rates, there remains a knowledge gap regarding healthcare resource utilization and the role of comorbidities in shaping outcomes. This study aims to identify such associations to improve patient care and enhance quality-adjusted life years

Materials and Methods/Case Presentation/Objective: We conducted a retrospective study using the 2022 Nationwide Readmissions Database (NRD), part of the Healthcare Cost and Utilization Project. Patients hospitalized with a diagnosis of Hodgkin lymphoma between January and October were selected as the study population. The first readmission within 90 days of the initial (index) hospitalization was used to define the readmission cohort. Using survey-weighted logistic, linear, and Cox regression models, we examined clinical and hospital-level characteristics and identified predictors of 90-day readmission

Results/Description/Main Outcome Measures: We identified 7,851.91 index admissions, of which 2,310.21 were readmitted within 90 days of their initial hospitalization. During the index stay, 366.45 patients died. The average length of stay for index admissions was 8.05 days, with mean total charges of $127,682.40 and mean costs of $31,178.30. For those who were readmitted, the average stay was 7.44 days, with mean charges of $118,297.70 and mean costs of $29,596.14. In total, the readmission group accounted for 17,177.16 hospital days, $271 million in charges, and $67.7 million in costs.In multivariable analysis, several factors were significantly associated with 90-day readmission. Increasing age was linked to a lower risk (aHR 0.987, p < 0.001), while discharge from an urban teaching hospital was associated with a higher risk (aHR 1.39, p = 0.002). Compared to those with private insurance, patients with Medicaid (aHR 0.68, p < 0.001) or other government insurance (aHR 0.39, p = 0.007) had a reduced likelihood of readmission. Pregnancy (aHR 0.42, p = 0.018) and obesity (aHR 0.70, p < 0.001) were also associated with decreased risk. After removing Hodgkin lymphoma–specific and chemotherapy/immunotherapy encounter codes, we found that sepsis was the leading cause of 90-day readmission, including cases related to E. coli, other bacteria, and unspecified organisms. This highlights infection as a persistent challenge following treatment. Other frequent causes included neutropenia, COVID-19, pneumonia, and acute kidney injury. Additional readmissions were attributed to complications from hypertension with heart and kidney disease, transplant-related issues, febrile episodes, and pain crises

Conclusions: Despite advances in survival, Hodgkin lymphoma patients remain vulnerable to early readmissions driven largely by infections and treatment-related complications. Identifying at-risk populations and improving discharge planning could reduce avoidable hospitalizations and resource burden