{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T11:10:45Z","timestamp":1788001845160,"version":"build-2784847793"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Graft\u2010versus\u2010host disease (GVHD) is a recognized complication among individuals undergoing bone marrow transplantation (BMT). There is a requirement for supplementary data regarding the in\u2010patient outcomes of GVHD in individuals who have undergone BMT. Our analysis seeks to assess the healthcare burden and outcomes associated with GVHD in hospitalized patients who have undergone BMT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>In this retrospective study, we used data from the National Inpatient Sample (NIS) database spanning from 2016 to 2019. Utilizing ICD\u201010 codes, we distinguished hospitalizations related to BMT and grouped them into two categories: those with GVHD and those without GVHD. Our areas of focus included in\u2010hospital mortality, length of stay, charges, and associations related to GVHD. Unadjusted odds ratios\/coefficients were computed through univariable analysis, followed by adjusted odds ratios (aORs)\/coefficients from multivariable analysis that considered potential confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2016 to 2019, data were collected from 13,999 hospitalizations with bone marrow transplants. Among them, 836 had GVHD cases. Patient characteristics showed slight differences in mean age and demographics between the two groups, with GVHD patients having a mean age of 51.61\u2009years and higher percentages of males and whites. Analyzing outcomes, patients with GVHD experienced significantly longer hospital stays (41.4\u2009days vs. 21.3\u2009days) and higher total hospital charges ($824,058 vs. $335,765). Adjusting for confounding factors, GVHD posed a substantial risk. The aOR for mortality in GVHD hospitalizations was 7.20 (95% CI: 5.54\u20139.36, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). The coefficient for the length of stay was 19.36\u2009days (95% CI: 17.29\u201321.42, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), and the coefficient for total hospital charges was $453,733 (95% CI: $396,577 to $510,889, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) in GVHD cases. Furthermore, GVHD in patients was associated with elevated risks of various medical conditions. The aORs for sepsis, pneumonia, acute respiratory failure, intubation and mechanical ventilation, <jats:italic>Clostridium difficile<\/jats:italic> infection, and acute kidney injury (AKI) in GVHD patients were 2.79 (95% CI: 2.28\u20133.41, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), 3.30 (95% CI: 2.57\u20134.24, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), 5.10 (95% CI: 4.01\u20136.49, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), 4.88 (95% CI: 3.75\u20136.34, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), 1.45 (95% CI: 1.13\u20131.86, <jats:italic>p<\/jats:italic>\u2009=\u2009.003), and 3.57 (95% CI: 2.97\u20134.29, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>GVHD in individuals undergoing BMT is linked to elevated mortality rates, prolonged hospitalization, and higher healthcare costs. Moreover, they face a significantly increased risk of developing complications, such as sepsis, pneumonia, acute respiratory failure, <jats:italic>C. difficile<\/jats:italic> infection, and AKI. These results underscore the critical need for vigilant monitoring and effective GVHD management to improve patient outcomes and reduce the complications associated with BMT. Nevertheless, further prospective studies are essential to obtain a more profound understanding and a comprehensive assessment of outcomes in these hospitalized patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14281","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T03:50:08Z","timestamp":1723521008000},"page":"758-764","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Graft\u2010versus\u2010host disease in patients with bone marrow transplants: A retrospective study analyzing outcomes and healthcare burden in <scp>US<\/scp> hospitals"],"prefix":"10.1111","volume":"113","author":[{"given":"Rushin","family":"Patel","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Community Hospital of San Bernardino  San Bernardino California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afoma","family":"Onyechi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine SSM Health St. Mary's Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ohemeng\u2010Dapaah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine SSM Health St. Mary's Hospital  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mrunal","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Trumbull Regional Medical Center  Warren Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshil","family":"Patel","sequence":"additional","affiliation":[{"name":"Clinical Research Program, Graduate College, Rush University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zalak","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of California Riverside  Riverside California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Han","family":"Chen","sequence":"additional","affiliation":[{"name":"Englewood Hospital and Medical Center  Englewood New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2242-0447","authenticated-orcid":false,"given":"Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine University of California Riverside  Riverside California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409\u2010023\u201001930\u20108"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41409\u2010022\u201001736\u20100"},{"key":"e_1_2_9_4_1","unstructured":"Graft\u2010Versus\u2010Host Disease. 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