PDF(Pubmed)
Abstract：
Introduction Diffuse large B-cell lymphoma (DLBCL) may be complicated by hypercalcemia at various stages of treatment. The impact of hypercalcemia on chemotherapy admission outcomes in DLBCL is not well described. Methods In a retrospective analysis, using the National Inpatient Sample database (2018 - 2020), patients with DLBCL admitted for chemotherapy were dichotomized based on the presence of hypercalcemia. Our primary outcome was all-cause mortality. Secondary outcomes included length of stay (LOS), total charge, rate of acute kidney injury (AKI), tumor lysis syndrome (TLS), hyperkalemia, metabolic acidosis, acute encephalopathy, septic shock, Clostridiodes difficile infection, acute respiratory failure, and venous thromboembolic events (VTE). Results We identified 78,955 patients, among whom 1,375 (1.74%) had hypercalcemia. Hypercalcemia was associated with higher odds of all-cause mortality (aOR:3.05, p-value:0.020), TLS (aOR:8.81, p-value<0.001), acute metabolic encephalopathy (aOR:4.89, p-value<0.001), AKI (aOR:5.29, p-value<0.001), hyperkalemia (aOR:2.84, p-value:0.002), metabolic acidosis (aOR:3.94, p-value<0.001) and respiratory failure (aOR:2.29, p-value:0.007) and increased LOS by 1 day and total charge by 12, 501 USD. Conclusions In patients with DLBCL admitted for inpatient chemotherapy, those with hypercalcemia compared to a cohort without had higher odds of; all-cause mortality, TLS, AKI, acute encephalopathy, acute metabolic acidosis, hyperkalemia, and acute respiratory failure as well as higher LOS and total charge.
摘要：
背景技术弥漫性大B细胞淋巴瘤(DLBCL)可在治疗的不同阶段并发高钙血症。高钙血症对DLBCL化疗入院结果的影响尚未得到很好的描述。方法采用回顾性分析,使用国家住院患者样本数据库(2018-2020年)，接受化疗的DLBCL患者根据是否存在高钙血症进行分类.我们的主要结果是全因死亡率。次要结果包括住院时间（LOS），总电荷,急性肾损伤（AKI）的发生率，肿瘤溶解综合征（TLS），高钾血症,代谢性酸中毒,急性脑病,感染性休克,艰难梭菌感染，急性呼吸衰竭,和静脉血栓栓塞事件（VTE）。结果我们确定了78,955例患者，其中1,375人(1.74%)患有高钙血症。高钙血症与全因死亡率的几率较高相关(aOR:3.05,p值:0.020),TLS（AOR：8.81，p值<0.001），急性代谢性脑病（AOR：4.89，p值<0.001），AKI（AOR：5.29，p值<0.001），高钾血症（AOR：2.84，p值：0.002），代谢性酸中毒（aOR：3.94，p值<0.001）和呼吸衰竭（aOR：2.29，p值：0.007），LOS增加1天，总费用增加12501美元。结论接受住院化疗的DLBCL患者,与没有高钙血症的人群相比，高钙血症的人群有更高的几率；全因死亡率，TLS,AKI,急性脑病,急性代谢性酸中毒，高钾血症,和急性呼吸衰竭以及较高的LOS和总电荷。
