Skip to main content
Hospitalization rates for complications due to systemic therapy in the United States
Scientific Reports
  • Anshul Saxena, Baptist Health Medical Group
  • Muni Rubens, Miami Cancer Institute
  • Venkataraghavan Ramamoorthy, Baptist Health South Florida
  • Raees Tonse, Miami Cancer Institute
  • Emir Veledar, Baptist Health South Florida
  • Peter McGranaghan, Baptist Health South Florida
  • Michael Chuong, Miami Cancer Institute
  • Matthew Hall, Miami Cancer Institute
  • Yazmin Odia, Miami Cancer Institute
  • Minesh Mehta, Miami Cancer Institute
  • Rupesh Kotecha, Miami Cancer Institute

The aim of this study was to estimate the trends and burdens associated with systemic therapy-related hospitalizations, using nationally representative data. National Inpatient Sample data from 2005 to 2016 was used to identify systemic therapy-related complications using ICD-9 and ICD-10 external causes-of-injury codes. The primary outcome was hospitalization rates, while secondary outcomes were cost and in-hospital mortality. Overall, there were 443,222,223 hospitalizations during the study period, of which 2,419,722 were due to complications of systemic therapy. The average annual percentage change of these hospitalizations was 8.1%, compared to - 0.5% for general hospitalizations. The three most common causes for hospitalization were anemia (12.8%), neutropenia (10.8%), and sepsis (7.8%). Hospitalization rates had the highest relative increases for sepsis (1.9-fold) and acute kidney injury (1.6-fold), and the highest relative decrease for dehydration (0.21-fold) and fever of unknown origin (0.35-fold). Complications with the highest total charges were anemia ($4.6 billion), neutropenia ($3.0 billion), and sepsis ($2.5 billion). The leading causes of in-hospital mortality associated with systemic therapy were sepsis (15.8%), pneumonia (7.6%), and acute kidney injury (7.0%). Promoting initiatives such as rule OP-35, improving access to and providing coordinated care, developing systems leading to early identification and management of symptoms, and expanding urgent care access, can decrease these hospitalizations and the burden they carry on the healthcare system.

Publication Date
Content Type
PubMed ID:
Additional Authors:

Additional authors and institutional affiliations

Copyright © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit
Citation Information

Scientific Reports (2021) 11(1):7385