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. 2011 May;22(5):1181-1188.
doi: 10.1093/annonc/mdq552. Epub 2010 Nov 1.

Health care utilization and mortality among elderly patients with myelodysplastic syndromes

K J Lindquist  1 , M D Danese  2 , J Mikhael  3 , K B Knopf  4 , R I Griffiths  5
Affiliations

Health care utilization and mortality among elderly patients with myelodysplastic syndromes

K J Lindquist et al. Ann Oncol. 2011 May.

Abstract

Background: Mortality in patients with myelodysplastic syndromes (MDS) is high, and patients are likely to require hospitalizations, emergency department (ED) visits, and transfusions. The relationships between these events and the MDS complications of anemia, neutropenia, and thrombocytopenia are not well understood.

Patients and methods: A total of 1864 patients registered in the United States' Surveillance Epidemiology and End Results (SEER) program and aged ≥ 66 years old when diagnosed with MDS in 2001 or 2002 were included. Medicare claims were used to identify MDS complications and utilization (hospitalizations, ED visits, and transfusions) until death or the end of 2005. Mortality was based on SEER data. Kaplan-Meier incidence rates were estimated and multivariable Cox models were used to study the association between complications and outcomes.

Results: The 3-year incidence of anemia, neutropenia, and thrombocytopenia was 81%, 25%, and 41%, and the incidence of hospitalization, ED visit, and transfusion was 62%, 42%, and 45%, respectively. Median survival time was 22 months. Cytopenia complications were significantly associated with each of these outcomes.

Conclusions: All types of cytopenia are common among patients with MDS and are risk factors for high rates of health care utilization and mortality. Management of the complications of MDS may improve patient outcomes.

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Figures

Figure 1.
Figure 1.
Cumulative incidence of anemia, neutropenia, and thrombocytopenia after diagnosis in patients diagnosed with myelodysplastic syndromes in the United States, 2001–2002.
Figure 2.
Figure 2.
Incidence of hospitalization (from top to bottom: any reason, bleeding event, fever), emergency department (ED) visits, transfusions (from top to bottom: any type, red blood cell, other/unknown, platelet), and death after diagnosis in patients diagnosed with myelodysplastic syndromes in the United States, 2001–2002.
Figure 3.
Figure 3.
Multivariable analysis of the characteristics and complications associated with health care utilization and mortality in patients diagnosed with myelodysplastic syndromes in the United States, 2001–2002.
See this image and copyright information in PMC

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