Epidemiological Disparities And Mortality Rates In Multiple Myeloma Patients With AKI: A Retrospective Analysis

Acute Kidney Injury (AKI) is a frequently observed complication in cancer patients and is linked to higher mortality rates. Several studies have explored the relationship between kidney function and cancer. Our study aimed to identify the epidemiological characteristics and disparities among patients with multiple myeloma who experience AKI upon admission.

We performed a retrospective analysis using the 2022 National Inpatient Sample database to identify multiple myeloma patients with and without acute kidney injury (AKI) using ICD-10 codes. We examined epidemiological factors such as mean age, total charges, and hospital stay length. A chi-square test compared mortality rates, racial disparities, and hospital regions between the groups. Additionally, we used multivariate logistic regression to calculate the odds ratio of AKI in multiple myeloma patients

In 2022, there were a total of 23,248 hospitalizations for Multiple Myeloma and 1,075,751 for Acute Kidney Injury (AKI). Among the patients with Multiple Myeloma, 8,377 (56%) also had AKI. AKI in Multiple Myeloma patients is more common among older individuals, with a mean age of 71 years for those with AKI, compared to 69 years for those without AKI, which is statistically significant (p-value = 0.00). Furthermore, the mean length of hospital stay and total hospitalization charges were higher for Multiple Myeloma patients with AKI, averaging 10 days and $135734, respectively, versus 7 days and $106404.5 for those without AKI (p-value = 0.00). Gender disparities were noted, with a higher incidence of AKI among male patients (p-value = 0.00). Mortality rates were significantly elevated; patients with Multiple Myeloma and AKI had a mortality rate of 9.72%, compared to 3.27% for those without AKI (p-value = 0.00). Racial disparities were also observed: while the highest prevalence of Multiple Myeloma was found in the white population, the black population exhibited a higher incidence of AKI among Multiple Myeloma patients. Regarding patient disposition, 21.97% of Multiple Myeloma patients with AKI were discharged to skilled nursing facilities, while 25.56% required home healthcare services (p-value = 0.00). After adjusting for potential confounders, Multiple Myeloma patients with AKI had higher odds of mortality, with an odds ratio of 2.82 when compared to those without AKI. This finding was statistically significant, with a p-value of 0.000 and a 95% confidence interval of 2.5 to 3.1.

Our study found that patients with multiple myeloma who also have acute kidney injury (AKI) experience higher rates of mortality, longer hospital stays, and increased healthcare costs. This highlights the significant burden that these patients face. It is crucial to identify multiple myeloma patients with AKI early and monitor them closely to prevent adverse outcomes.