Contributions
Abstract: EP930
Type: E-Poster Presentation
Session title: Myelodysplastic syndromes - Clinical
Background
Myelodysplastic syndromes (MDS) are characterized by cytopenias, ineffective haematopoiesis, and a risk of progression to acute myeloid leukaemia (AML). MDS with ring sideroblasts (MDS-RS) is a subtype of MDS, constituting ¬ 3-10% of all cases of MDS, in which excess iron accumulates in the mitochondria of the erythroid precursors.. The main clinical issues are severe anaemia, chronic blood transfusion requirement, and the subsequent risk of iron overload.
The Hospital Episodes Statistics (HES) database in England contains universal coverage of secondary care data from NHS hospitals, covering three main patient groups: 1) inpatient patient care; 2) Outpatient appointments and attendances (OP); and 3) Emergency Room (ER) visits with approximately 17 million episodes recorded each year.
Aims
To describe patients diagnosed with MDS-RS in England. In terms of demographics and clinical characteristics and to quantify the associated healthcare resource use (HCRU) and tariffs for this patient cohort including inpatient, day case, outpatient, and A&E care.
Methods
All data within an observation period between 01 January 2015- 31 December 2019, to include baseline characteristics for patients with ICD10 diagnosis code of D461 (MDS) were extracted from HES and presented as crude counts. Descriptive statistics including frequency and percentage were calculated as categorical variables; whereas, mean, median and interquartile range (IQR) were calculated for continuous variables. Length of follow-up was calculated as the total number of days between diagnosis date (index date) and end of study period. Tariffs were derived based on case mix; a method of classifying patient care based on expected clinical resource use for the provision of that care.
Results
Overall 914 patients (mean age at inclusion 76 years [youngest; 20, oldest; 96]; 40.26% female) were identified. During a mean observation period of 24.62 months (IQR 28.65) 103 (11.27%) patients experienced a disorder of iron metabolism, 278 (30.42%) suffered from sepsis and 235 (25.71%) from heart failure.
52 (2.62%) patients had no inpatient admissions. For those who had ≥1 event, the mean number of inpatient blood transfusion events per-patient-per-year was 15.93 (IQR 12.68), the mean number of outpatient blood transfusion events per-patient-per-year was 3.55 (IQR 1.55), 443 patients (51.39%) had ≥12 visits per year.
Overall HCRU is split by inpatient and outpatient care and ER attendance. In the inpatient setting there were a mean of 19.2 admissions per-patient-per-year, of which 99.11% were elective (resulting in a mean of 15.79 bed days per-patient-per-year). In the outpatient setting there were a mean of 4.08 appointments per-patient-per-year. There were a mean of 2.54 ER visits per-patient-per-year.
Overall tariff costs to the health service per-patient-per-year were £19,047 (inpatient tariff £10,389, outpatient tariff £579, transfusion £7,686, ER visits £393).
Conclusion
The results of this database analysis offer insights into the real-world management of patients with MDS-RS in England and the HCRU with its management. A burden on patients and the healthcare system has been identified due to the frequent hospitalisations and secondary care visits. This highlights the need for novel treatment options in the management of MDS-RS.
Keyword(s): Myeloid leukemia, Red blood cell, Transfusion
Abstract: EP930
Type: E-Poster Presentation
Session title: Myelodysplastic syndromes - Clinical
Background
Myelodysplastic syndromes (MDS) are characterized by cytopenias, ineffective haematopoiesis, and a risk of progression to acute myeloid leukaemia (AML). MDS with ring sideroblasts (MDS-RS) is a subtype of MDS, constituting ¬ 3-10% of all cases of MDS, in which excess iron accumulates in the mitochondria of the erythroid precursors.. The main clinical issues are severe anaemia, chronic blood transfusion requirement, and the subsequent risk of iron overload.
The Hospital Episodes Statistics (HES) database in England contains universal coverage of secondary care data from NHS hospitals, covering three main patient groups: 1) inpatient patient care; 2) Outpatient appointments and attendances (OP); and 3) Emergency Room (ER) visits with approximately 17 million episodes recorded each year.
Aims
To describe patients diagnosed with MDS-RS in England. In terms of demographics and clinical characteristics and to quantify the associated healthcare resource use (HCRU) and tariffs for this patient cohort including inpatient, day case, outpatient, and A&E care.
Methods
All data within an observation period between 01 January 2015- 31 December 2019, to include baseline characteristics for patients with ICD10 diagnosis code of D461 (MDS) were extracted from HES and presented as crude counts. Descriptive statistics including frequency and percentage were calculated as categorical variables; whereas, mean, median and interquartile range (IQR) were calculated for continuous variables. Length of follow-up was calculated as the total number of days between diagnosis date (index date) and end of study period. Tariffs were derived based on case mix; a method of classifying patient care based on expected clinical resource use for the provision of that care.
Results
Overall 914 patients (mean age at inclusion 76 years [youngest; 20, oldest; 96]; 40.26% female) were identified. During a mean observation period of 24.62 months (IQR 28.65) 103 (11.27%) patients experienced a disorder of iron metabolism, 278 (30.42%) suffered from sepsis and 235 (25.71%) from heart failure.
52 (2.62%) patients had no inpatient admissions. For those who had ≥1 event, the mean number of inpatient blood transfusion events per-patient-per-year was 15.93 (IQR 12.68), the mean number of outpatient blood transfusion events per-patient-per-year was 3.55 (IQR 1.55), 443 patients (51.39%) had ≥12 visits per year.
Overall HCRU is split by inpatient and outpatient care and ER attendance. In the inpatient setting there were a mean of 19.2 admissions per-patient-per-year, of which 99.11% were elective (resulting in a mean of 15.79 bed days per-patient-per-year). In the outpatient setting there were a mean of 4.08 appointments per-patient-per-year. There were a mean of 2.54 ER visits per-patient-per-year.
Overall tariff costs to the health service per-patient-per-year were £19,047 (inpatient tariff £10,389, outpatient tariff £579, transfusion £7,686, ER visits £393).
Conclusion
The results of this database analysis offer insights into the real-world management of patients with MDS-RS in England and the HCRU with its management. A burden on patients and the healthcare system has been identified due to the frequent hospitalisations and secondary care visits. This highlights the need for novel treatment options in the management of MDS-RS.
Keyword(s): Myeloid leukemia, Red blood cell, Transfusion