MM-756 A National Database Study on the Trends of Palliative Care Involvement in Multiple Myeloma—Social Disparities Hospital Factors, and Outcomes

Early involvement of palliative care (PC) for people with cancer results in improved quality of life, lower symptom burden, and, in some cases, prolonged life. Despite advancements in treatment, multiple myeloma (MM) remains incurable, with a variable clinical course and a considerable burden on patients’ quality of life. Assess the effect of patient and hospital factors on PC involvement for MM patients and the association between PC involvement and inpatient mortality, hospitalization cost, and length of stay. Retrospective cross-sectional study of hospitalized MM patients using National Inpatient Database (2016-2020) ICD-10 codes. Logistic regression assessed patient and hospital factors influencing PC involvement and its association with inpatient mortality using the STATA BE 18.0 software. Linear regression analyzed the association between PC involvement and hospitalization costs and length of stay. Results were adjusted for age, gender, race, insurance type, smoking, alcohol use, diabetes, hypertension, chronic kidney disease (CKD), obesity, and congestive heart failure (CHF). Variance inflation factor measured multicollinearity. Among 15,753 people admitted with MM (mean age 63.67 ± 9.21 years, 41.76% female), PC was involved for 6.98% of the patients. Older age (OR 1.032; 95% CI, 1.030-1.034), concomitant CHF (OR 1.192; 95% CI, 1.110-1.280), and CKD (OR 1.739; 95% CI, 1.043-2.897) correlated with significantly higher PC involvement. Gender and race did not significantly relate to PC involvement. Hospitals located in northeastern (OR 1.020; 95% CI, 0.953-1.093) and midwestern (OR 1.054; 95% CI, 0.986-1.127) states had a higher PC involvement than hospitals in southern states (OR 0.942; 95% CI, 0.884-1.003). PC involvement was significantly associated with higher rates of inpatient mortality (OR 16.018; 95% CI, 15.118-16.972), hospitalization cost (OR 1.313; 95% CI, 1.288-1.339), and length of stay (OR 1.312; 95% CI, 1.290-1.335). Collinearity existed between insurance type and hospital location. In MM, PC involvement is influenced by age, co-morbidities, and hospital location. Its association with higher inpatient mortality, increased hospitalization costs, and length of stay highlights the need for early and equitable PC integration to enhance MM patient outcomes. Longitudinal studies are required to evaluate the time to PC involvement and its effect on patient outcomes.