Impact of Frailty on Hospitalized Patients with Myelodysplastic Syndrome: A Retrospective Nationwide Analysis
Abstract
This study examines the impact of frailty on clinical outcomes among patients with myelodysplastic syndrome (MDS), a heterogeneous group of neoplasms arising from abnormalities in hematopoietic stem cell proliferation and differentiation in the bone marrow. Frailty reflects increased vulnerability to internal and external stressors. Patients with both MDS and frailty were identified using the 2021–2022 National Inpatient Sample (NIS) through International Classification of Diseases, Tenth Revision codes. Clinical outcomes of interest included risk of mortality, severity of illness, length of stay, and hospitalization costs. To estimate the association between these outcomes and frailty, ordered logistic regression was used for mortality risk and severity of illness (ordinal variables), while linear regression was applied for length of stay and hospitalization costs (continuous variables). To further reduce potential confounding, propensity score matching (PSM) was also employed as a robustness check. According to our PSM results, which provide a more balanced comparison between frail and nonfrail patients, frail MDS patients had higher odds of being in a higher mortality risk category (odds ratio [OR] = 1.227, 95% confidence interval [CI]: 1.133–1.330, P < 0.001) and in a higher severity of illness category (OR = 1.453, 95% CI: 1.339–1.577, P < 0.001). They also experienced longer hospital stays (β = 1.33, 95% CI: 0.93–1.72, P < 0.001) and higher hospitalization costs (β = 0.08, 95% CI: 0.04–0.12, P < 0.001). Frail patients also have greater rates of hemochromatosis (OR = 1.45, 95% CI: 1.003–2.096, P < 0.043). Our findings suggest that having both frailty and MDS may contribute to greater clinical and economic burden, efforts to address frailty in patients with MDS may help reduce disease severity, mortality risk, length of hospital stay, and hospitalization costs.
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BibTeX
@article{omari2026impact,
title = {{Impact of Frailty on Hospitalized Patients with Myelodysplastic Syndrome: A Retrospective Nationwide Analysis}},
author = {Sara Omari and Mehdi Barati and Daniel Nathan Thompson and Hadis Tavana and Saad Javaid and Kelly Frasier and Vivian Li and Julia R. Vinagolu-Baur and Olivia Carll},
journal = {Journal of Applied Hematology},
year = {2026},
month = jul,
doi = {10.4103/joah.joah_34_26},
url = {https://doi.org/10.4103/joah.joah_34_26},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Impact of Frailty on Hospitalized Patients with Myelodysplastic Syndrome: A Retrospective Nationwide Analysis
AU - Sara Omari
AU - Mehdi Barati
AU - Daniel Nathan Thompson
AU - Hadis Tavana
AU - Saad Javaid
AU - Kelly Frasier
AU - Vivian Li
AU - Julia R. Vinagolu-Baur
AU - Olivia Carll
PY - 2026
DA - 2026/07/01
JO - Journal of Applied Hematology
DO - 10.4103/joah.joah_34_26
UR - https://doi.org/10.4103/joah.joah_34_26
AB - This study examines the impact of frailty on clinical outcomes among patients with myelodysplastic syndrome (MDS), a heterogeneous group of neoplasms arising from abnormalities in hematopoietic stem cell proliferation and differentiation in the bone marrow. Frailty reflects increased vulnerability to internal and external stressors. Patients with both MDS and frailty were identified using the 2021–2022 National Inpatient Sample (NIS) through International Classification of Diseases, Tenth Revision codes. Clinical outcomes of interest included risk of mortality, severity of illness, length of stay, and hospitalization costs. To estimate the association between these outcomes and frailty, ordered logistic regression was used for mortality risk and severity of illness (ordinal variables), while linear regression was applied for length of stay and hospitalization costs (continuous variables). To further reduce potential confounding, propensity score matching (PSM) was also employed as a robustness check. According to our PSM results, which provide a more balanced comparison between frail and nonfrail patients, frail MDS patients had higher odds of being in a higher mortality risk category (odds ratio [OR] = 1.227, 95% confidence interval [CI]: 1.133–1.330, P < 0.001) and in a higher severity of illness category (OR = 1.453, 95% CI: 1.339–1.577, P < 0.001). They also experienced longer hospital stays (β = 1.33, 95% CI: 0.93–1.72, P < 0.001) and higher hospitalization costs (β = 0.08, 95% CI: 0.04–0.12, P < 0.001). Frail patients also have greater rates of hemochromatosis (OR = 1.45, 95% CI: 1.003–2.096, P < 0.043). Our findings suggest that having both frailty and MDS may contribute to greater clinical and economic burden, efforts to address frailty in patients with MDS may help reduce disease severity, mortality risk, length of hospital stay, and hospitalization costs.
SN - 1658-5127
SN - 2454-6976
ER -