Early discharge after intensive AML, MDS chemo can reduce costs, antibiotics use

the Oncology Nurse Advisor take:

Early discharge following intensive acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) can reduce costs and use of intravenous antibiotics, according to a new study published online ahead of print in JAMA Oncology.

Because adults with AML or MDS typically remain hospitalized after induction or salvage chemotherapy, health care costs are driven up by the prolonged inpatient stay. Researchers sought to evaluate whether early discharge and outpatient management would be safe and reduce costs for these patients.

For the study, researchers from the University of Washington and Fred Hutchinson Cancer Research Center in Seattle enrolled 146 patients with AML or MDS. Of those, 107 were discharged early and 29 served as inpatient controls. The early discharge patients were released from the hospital at the completion of chemotherapy and were provided with supportive care in the outpatient setting.

Results showed no significant difference in intensive care unit (ICU) days or transfusions per study day between the two treatment arms. Early discharge patients had more positive blood cultures than the inpatient controls but required fewer intravenous antibiotics. Costs were also lower for the early discharge group than for inpatients but had increased costs per inpatient day when readmitted for complications.