Clinical Outcome and Prognostication of Patients With Inflammatory and Immune Myopathies With and Without Chemotherapy in the United States

Aim To compare the clinical outcome and in-hospital complication risk with chemotherapy and without chemotherapy in patients with inflammatory and immune myopathies (IIM). Methods We obtained data for IIM patients admitted to hospitals in the United States from 2017 to 2018 with a primary diagnosis of IIM using a large national database. We determined the rate and pattern of utilization of associated in-hospital outcomes of chemotherapy in this patient population. Results A total of 5,360 patients had IIM, of which 315 (5.8%) received chemotherapy for the underlying malignancies and 5,045 (94.2%) did not. No significant racial or gender discrepancies were observed between the two groups. Patients who received chemotherapy had more in-hospital complications, including sepsis [79 (25.1%) vs. 585 (11.6%), p<0.01] and acute kidney injury [75 (23.8%) vs. 665 (13.2%), p<0.01]. The number of deaths was higher in the chemotherapy group [125 (39.7%) vs. 190 (3.8%)]. Further analysis of patients who died in the chemotherapy group showed that myocardial infarction [20 (6.3%)] and pneumonia [45 (14.3%)] were the leading causes of death. Conclusion In hospitalization complications such as sepsis and acute kidney injury were higher in patients who received chemotherapy in IIM patients; however, patients who died had a higher risk of myocardial infarction and pneumonia, so routine cardiac and pulmonary evaluation should be done during hospitalization of this patient population.