Clinical Outcomes for Female Patients Following Hematopoietic Stem Cell Transplant: An Analysis of the National Inpatient Sample

Background: As hematopoietic stem cell transplant (HSCT) grows in accessibility and utility, it remains imperative to understand outcomes for its recipients. Limited data is available on the sex-based correlations for this steadily increasing patient population. We sought to examine the National Inpatient Sample (NIS) database to describe in-hospital outcomes among the female population who have received a HSCT. Methods: Data were extracted from the NIS Database from 2019 and 2020. The NIS was searched for hospitalizations of all patients greater than 18 years old who had previously received a HSCT and were hospitalized thereafter. We then analyzed the outcomes of female patients. Multivariate logistic regression analysis was used to adjust for confounders; SPSS software was used for statistical analysis. The primary outcome was inpatient mortality and secondary outcomes are listed below. Results: This study included 8,302 patients who had received a HSCT, of which 3636 (43.8%) were identified as female. Female recipients of a HSCT had a slightly higher prevalence of obesity (7.5% versus 7.0%, p<0.001), as well as lower prevalence of smoking (16.5% versus 20.5%, p<0.001), hypertension (21.8% versus 23.7%, p<0.001), and chronic kidney disease (19.3% versus 21.3%, p<0.001). Multivariate regression demonstrated that female recipients of a HSCT had higher inpatient mortality (OR 1.721, CI 1.572-1.884, p<0.001). On secondary analysis, female HSCT recipients were found to be more likely to have anemia (OR 1.790, CI 1.746-1.836, p<0.001), thrombocytopenia (OR 1.692, CI 1.621-1.765, p<0.001), hypertension (OR 1.674, CI 1.615-1.736, p<0.001), acute kidney failure (OR 1.698, CI 1.635-1.764, p<0.001), all-cause arrhythmias (OR 1.588, CI 1.502-1.680, p<0.001), all-cause heart block (OR 1.441, CI 1.323-1.570, p<0.001), all-cause sepsis (OR 1.859, CI 1.789-1.932, p<0.001), all-cause coagulopathies (OR 1.744, CI 1.605-1.895, p<0.001), and acute heart failure (OR 1.734, CI 1.658-1.815, p<0.001). Conclusion: In this nationally-representative, population-based retrospective cohort study, female patients who have received a HSCT and were subsequently hospitalized were associated with higher mortality and worse outcomes.