Comparison of mortality and medical complications between older and younger malignant melanoma inpatients.

BACKGROUND Previous studies have identified older age as a negative prognostic factor in malignant melanoma patients. OBJECTIVES To compare comorbidities, medical complications, and inpatient mortality between younger and older malignant melanoma inpatients. METHODS All adult patient encounters with a diagnosis of cutaneous malignant melanoma were identified using the 2003-2012 National Inpatient Sample database. Concurrent comorbidities and inpatient medical complications were queried. Comparisons were made between older and younger adults, defined as ≥65 years and 18-64 years, respectively RESULTS: In total, 8,153 patient encounters were identified in the database (51.6% older and 48.4% younger). Older adults had a higher prevalence of numerous comorbidities, including chronic pulmonary disease, chronic renal failure, congestive heart failure, diabetes mellitus, hypertension, hypothyroidism, peripheral vascular disease, and pulmonary circulation disorder (p<0.001). In contrast, younger adults were more likely to have obesity (p<0.001) and coagulopathy (p=0.005). On multivariable analysis of medical complications, older adult inpatients were more likely to experience urinary tract infection (OR=1.54, p=0.021), but less likely to experience acute respiratory failure (OR=0.46, p=0.012) and venous thromboembolism (OR=0.44, p=0.026). Notably, inpatient mortality did not significantly differ. CONCLUSION Older adult inpatients with malignant melanoma have different comorbidities than younger patients and have a larger overall comorbidity burden. Surprisingly, however, the odds of most inpatient medical complications and mortality were found to be similar in younger versus older patients. This article is protected by copyright. All rights reserved.