Hospitalization burden among children and adolescents diagnosed with leukemia and lymphoma by treatment modalities in the US.
Notice bibliographique
Résumé
19 Background: Leukemia and lymphoma are among the most common pediatric and adolescent cancers in the US, which often require hospital-based multimodal treatments, including chemotherapy, radiation therapy, immunotherapy, and stem cell transplantation. To date, little is known about hospitalization burden, including hospitalization cost. Methods: The cross-sectional 2019 Kids' Inpatient Database, which is part of the nationally representative Healthcare Cost and Utilization Project data, was used to identify hospitalizations for children and adolescents aged 0–18 years treated for leukemia or lymphoma. Treatment was classified as: 1) chemotherapy only; 2) stem cell transplant with chemotherapy; 3) transplant without chemotherapy; and 4) others. Multivariable negative binomial regression and log-normal regression were used to examine length of stay (LOS) and total hospital cost by modality, respectively. Patient- and hospital- level characteristics included in adjusted analyses were age, sex, primary payer, hospital bed size, and hospital region. Sample weights were used to generate national estimates. Results: A total of 9,221 hospitalizations were identified, representing 12,294 hospitalizations nationwide. Among these, 6,438 (52.4%) involved chemotherapy alone, 163 (1.3%) involved both chemotherapy and stem cell transplantation, 78 (0.6%) involved stem cell transplantation without chemotherapy, and the remaining 5,615 (45.7%) received other types of treatment. The median hospitalization costs ranged from $18,430 for chemotherapy only to $239,492 for transplantation with chemotherapy and LOS ranged from 5 days to 41 days, respectively. In multivariable regressions, transplantation with chemotherapy and transplantation without chemotherapy were associated with substantially higher hospitalization costs and longer LOS compared to chemotherapy only (Table; all p < .001). Conclusions: Hospitalization burden among children diagnosed with leukemia and lymphoma varies substantially by treatment modality, with stem cell transplantation combined with chemotherapy being associated with the longest LOS and highest hospital costs. These findings may inform efforts to improve financial and logistical support for affected families. Treatment modality Hospitalization cost Multiplicative change in median cost LOS (days) Multiplicative change in LOS Median IQR Median IQR Chemotherapy only $18,430 ($8,342, $52,998) ref 5 (3, 13) ref Transplant with chemotherapy $239,492 ($139,743, $398,797) 5.2 (4.3, 6.3) 41 (31, 64) 10.8 (9.2, 12.7) Transplant without chemotherapy $238,652 ($118,996, $344,741) 4.1 (3.3, 5.0) 37 (28, 52) 9.3 (7.1, 12.3) Other treatments $9,803 ($5,346, $20,307) 0.6 (0.5, 0.7) 3 (2, 6) 0.5 (0.5, 0.6)
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».