Agranulocytosis Secondary to Cancer Chemotherapy Associated With Higher In-Hospital Mortality in Patients With Central Line Insertion During a Hospital Stay

• Published in: Curēus (Palo Alto, CA) Vol. 15; no. 2; p. e34717
• Main Authors: Mohamed Jiffry, Mohamed Z, Khan, Aimal, Carmona Pires, Felipe, Okam, Nkechi A, Vargas, Jonathan, Moin, Kayvon, Josephs, Meagan
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 07-02-2023; Cureus
• Subjects: Age groups; Cancer; Catheters; Chemotherapy; Chronic obstructive pulmonary disease; Comorbidity; Dementia; Diabetes; Heart attacks; Heart failure; Hematology; Hospitalization; Hospitals; Hypertension; Infections; Internal Medicine; Kidney diseases; Mortality; Neutropenia; Oncology; Patients; Regression analysis; Risk factors; in-hospital mortality; central line associated bloodstream infection; neutropenia; central venous catheter; agranulocytosis secondary to cancer chemotherapy
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.34717

Background Agranulocytosis secondary to cancer chemotherapy (ASCC) remains a leading cause of morbidity and mortality. Central line-associated bloodstream infections (CLABSI) are also particularly prevalent in these populations and may portend a poorer outcome. Our study serves to investigate the relationship between patients with agranulocytosis secondary to cancer chemotherapy and the insertion of a central venous catheter (CVC) with respect to in-hospital mortality. Methods and results We utilized the National Inpatient Survey 2019 database. We utilized the International Classification of Diseases (ICD)-10 CM codes to identify ASCC and other medical comorbidities. We utilized ICD-10 PCS codes to identify CVC insertions. Multivariate logistic regression was utilized to study the effect of CVC insertion on in-hospital mortality. In patients with ASCC, CVC insertion was associated with a higher in-hospital mortality (unadjusted: 11.9% vs. 1%, p<0.001, adjusted OR 19.27, 95% CI 5.84 - 65.6, p<0.001) adjusted for baseline characteristics and other comorbidities. Patients in the study cohort who were older than 70 years of age also had a higher in-hospital mortality relative to younger age groups (adjusted OR 2.31, 95% CI 1.04-5.13, p<0.039). Conclusion In patients with ASCC, CVC insertion during hospitalization is associated with higher in-hospital mortality.