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Introduction and Objectives Clinical and epidemiological data suggest that depression may increase the risk for infection. Infection is a major cause of morbidity and mortality in patients undergoing stem cell transplantation. We investigated the impact of depression on infection rates in patients undergoing autologous or allogeneic stem cell transplant at a single center. Methods We analyzed data from University of California San Diego's Hematopoietic Stem Cell Transplant program to compare outcomes after autologous (n= 472) and allogeneic (n= 259) transplants in patients with hematologic malignancies and with an existing diagnosis of depression versus no depression. Using chi-square testing, we compared the infection rates between patients with or without depression. Results The study included 162 (22.2%) patients with depression versus 568 (77.9%) without depression who underwent allogeneic and autologous stem cell transplant between 2012 and 2017. Using Pearson Chi-square testing, patients with depression had a higher rate of infections (55.6%) versus patients without depression (41%, p= 0.001). Depression was associated with multiple infection sites (25% vs 17%, p=0.029), increased risk for bacterial infection (44% versus 28.5%, P<0.0001), and increased risk for fungal infection (10% versus 4%, P=0.002). In allogeneic transplant patients, depression led to significantly more acute graft versus host disease (65% versus 45%, p=0.003) and chronic graft versus host disease (41% versus vs 20.4). Conclusion In our retrospective analysis depression was associated with higher rates of overall infection, bacterial, and fungal infection among hematopoietic transplant patients. Depression was also associated with increased risk for both acute and chronic graft versus host disease. If our observation is confirmed prospectively, then interventions aimed at depression, might improve infection rates in transplant patients. [ABSTRACT FROM AUTHOR]

Introduction and Objectives Depression has been shown to increase health service utilization in cancer patients. Using data from EMR and BMT Registry we evaluated the impact of depression and comorbidity in BMT patients at our center. Methods A retrospective review of EMR of autologous (AUTO) and allogeneic (ALLO) stem cell transplant patients in UCSD Moores Cancer Center from 2012 to 2017. All diagnoses were defined by ICD-9/ICD-10 codes. Between group differences were assessed by t-test and chi-square test. Negative binomial modeling was performed to evaluate predictors of length of stay in the hospital (LOS) and clinic visits. The analyses were adjusted for age, gender, cancer diagnosis, comorbid conditions, GVHD status (for ALLO patients only) and Charlson Comorbidity Index (CCI). Results A total of 731 patients of whom 22.3% had depression were identified: AUTO Patients (N = 472; 18% Depressed [85]); ALLO patients (N = 259; 30.1% depressed [78]). For the entire population, we compared depressed patients (n = 540) to non-depressed patients (n = 158). Significant differences were observed for LOS (days), clinic visits, and CCI: 59.58+/-49.48 vs. 40.28 (p < 0.0001), 24.65+/-17.95 vs. 15.45+/-12.23 (p < 0.0001), and 3.91+/-2.27 vs. 3.36+/-1.82 (p = 0.005). For AUTO patients, the corresponding LOS, clinic visit, and CCI were 35.31+/-26.14 vs. 25.40+/-22.89 days (p = 0.002), 16.3+/-11.87 vs. 10.77+/-7.29 (p < 0.0001), 4.06 +/-2.52 vs. 3.38 +/-1.86 (p = 0.021) and for ALLO patients: 86.44+/-55.19 vs. 74.10+/-45.87 days (p = 0.094), 33.81+/-19.13 vs. 26.40+/-14.30 (p = 0.004) and 3.74+/-1.98 vs. 3.32+/-1.74 (p = 0.087). For AUTO patients, depression and infection were significant predictors for increased LOS and frequent clinic visits. For ALLO patients, significant predictors for increased LOS includes COPD and chronic GVHD which was a significant predictor for frequent clinic visits (Table 1). Conclusion Depression and comorbidities had a significant impact on health service utilization. Clinicians and health systems should recognize the importance of providing care in BMT patients with depression and managing comorbid conditions. [ABSTRACT FROM AUTHOR]