Psychological Risk Factors on Hematopoietic Stem Cell Transplantation Patients: Insights From National Readmission Database Analysis.

IF 3.3 2区医学 Q2 ONCOLOGY Psycho‐Oncology Pub Date : 2024-11-01 DOI:10.1002/pon.70032

Qi Zhang, Qiuyan Yu, Qian Chen, Hongjing Dong, Min Fang, Na Liu, Wen Li, Hui Wang, Nan Zhao, Xunxun Zhu, Kui Zhang, Chi Zhou

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Abstract

Background: Psychosocial risk factors (PSRFs) have emerged as important nontraditional risk factors for poor medical outcomes but have not been well-studied in the field of hematopoietic stem cell transplantation (HSCT).

Objectives: In this study, we retrospectively examined in-hospital and short-term outcomes in patients with PSRFs who underwent HSCT.

Methods: We used the National Readmission Database (NRD) to identify patients who underwent HSCT between 2011 and 2020. Patients were stratified based on the presence of either 0 or ≥ 1 PSRFs, which included factors such as mental illness, substance abuse, cognitive problems, a low income level, and an uninsured status. Patients were also classified into allogeneic-HSCT (allo-HSCT) and autologous-HSCT (auto-HSCT) groups. Our primary endpoints were in-hospital and short-term outcomes.

Results: In this nationally representative cohort, 90,747 patients underwent auto-HSCT, while 26,600 patients underwent allo-HSCT. In the auto-HSCT group, individuals with PSRFs exhibited notably higher in-hospital mortality (2.4% vs. 2.8%; p < 0.001) and 30-day all-cause readmission rates (14.4% vs. 17.8%; p < 0.001) compared to those without PSRFs. Similarly, within the allo-HSCT group, patients with PSRFs had significantly higher in-hospital mortality (5.4% vs. 6.4%; p < 0.001) and 30-day all-cause readmission rates (27.3% vs. 31.2%; p < 0.001) compared to those without PSRFs. After adjusting for risk factors, the presence of PSRFs emerged as a substantial predictor for heightened 30-day readmission in allo-HSCT and auto-HSCT.

Conclusion: The presence of PSRFs is correlated with poorer in-hospital and short-term outcomes after both allo-HSCT and auto-HSCT, with a more pronounced effect observed in allo-HSCT. This research underscores the significance of pinpointing high-risk patients and implies support for merging PSRFs after HSCT is beneficial.

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造血干细胞移植患者的心理风险因素：全国再入院数据库分析的启示。

背景：社会心理风险因素（PSRFs）已成为不良医疗结果的重要非传统风险因素，但在造血干细胞移植（HSCT）领域尚未得到充分研究：在这项研究中，我们对接受造血干细胞移植的PSRFs患者的院内和短期预后进行了回顾性研究：我们利用国家再入院数据库（NRD）识别了2011年至2020年间接受造血干细胞移植的患者。根据患者是否存在 0 个或≥1 个 PSRFs（包括精神疾病、药物滥用、认知问题、低收入水平和无保险状况等因素）对患者进行分层。患者还被分为异基因造血干细胞移植（allo-HSCT）组和自体造血干细胞移植（auto-HSCT）组。我们的主要终点是院内和短期疗效：在这个具有全国代表性的队列中，有90747名患者接受了自体造血干细胞移植，26600名患者接受了异体造血干细胞移植。在接受自体供血干细胞移植的患者中，有 PSRFs 的患者的院内死亡率明显更高（2.4% 对 2.8%；P 结论：PSRFs 的存在会对患者的生命造成威胁：PSRFs的存在与allo-HSCT和auto-HSCT后较差的院内和短期预后相关，在allo-HSCT中观察到的影响更为明显。这项研究强调了精确定位高风险患者的重要性，并意味着支持在造血干细胞移植后合并 PSRFs 是有益的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psycho‐Oncology 医学-心理学

CiteScore

6.30

自引率

8.30%

发文量

220

审稿时长

3-8 weeks

期刊介绍： Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology. This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues. Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.