Poor hospitalization outcomes in patients undergoing allogeneic hematopoietic stem cell transplant with hospital acquired influenza infection

Introduction: Although hospital-acquired influenza infection (HAII) is a known complication among immunocompromised patients, the data in the setting of hospitalization for allogeneic hematopoietic stem cell transplant (allo-HSCT) are scarce.Methods: A retrospective study using the National Inpatient sample database was done to determine the impact of HAII on hospitalization outcomes among patients admitted for allo-HSCT.Results: The data for 77 103 allo-HSCT weighted hospitalizations were collected between 2002 and 2019. Among these, only 314 (0.4%) allo-HSCT cases were billed for HAII. Patients with influenza were more likely to have comorbid conditions like chronic obstructive lung disease, diabetes mellitus, hypertension, and myocardial infarction. Multivariate logistic regression revealed that patients with influenza had a higher risk of all-cause mortality: (odds ratio = 4.87, 95% confidence interval: 3.63-6.54; p < .01). Patients with influenza also had statistically higher odds of developing acute kidney injury, septic shock, and respiratory failure requiring mechanical ventilation. They also had a significantly longer length of stay (34 days versus 26 days) and adjusted cost for hospitalization ($195 345 versus $121 967).Conclusion: Our large analysis of real-world data reveals that patients undergoing allo-HSCT that develop HAII are at substantially higher risk of inpatient complications and death.

Automated summary

Although HAII is a known complication among immunocompromised patients, there is limited data on its impact in the setting of allo-HSCT. A retrospective study using a national inpatient database found that patients with influenza had a higher risk of all-cause mortality and were more likely to develop complications such as acute kidney injury, septic shock, and respiratory failure requiring mechanical ventilation. They also had a longer length of stay and higher adjusted cost for hospitalization.