Acute organ dysfunction frequently complicates lymphoma hospitalizations because of infection, treatment-related toxicity, and disease progression.

Individual complications have been associated with adverse outcomes; however, the cumulative impact of increasing organ dysfunction burden has not been well characterized nationally.

We evaluated the association between organ dysfunction burden and inpatient mortality and healthcare utilization among hospitalized lymphoma patients.

• Design: Retrospective cohort study using the National Inpatient Sample (2018–2023).

• Population: Adult lymphoma hospitalizations identified using ICD-10-CM diagnosis codes.

• Organ Dysfunction Components: Sepsis, Acute kidney injury, Acute respiratory failure, Acute liver failure, Stroke

• Patients categorized into:

• 0 dysfunctions

• 1 dysfunction

• 2 dysfunctions

• ≥3 dysfunctions

• Primary Outcome: In-hospital mortality.

• Secondary Outcomes: Mechanical ventilation, dialysis utilization, length of stay, hospitalization charges.

• Statistical Analysis: Survey-weighted multivariable regression adjusting for demographic and hospital characteristics.

  • 268,043 lymphoma hospitalizations.

  • Approximately 1.34 million weighted admissions.

  • Mortality increased progressively with each additional organ dysfunction.

  • Compared with no dysfunction:

  • 1 dysfunction: OR 5.91

  • 2 dysfunctions: OR 25.18

  • ≥3 dysfunctions: OR 91.70

  • Every additional organ dysfunction increased mortality approximately four-fold (OR 4.12).

  • Organ dysfunction burden was associated with increased mechanical ventilation, dialysis utilization, length of stay, and hospitalization charges.

    • Mortality increased in a stepwise fashion with each additional acute organ dysfunction.

    • Even one dysfunction was associated with markedly higher mortality.

    • Three or more dysfunctions identified an extremely high-risk population.

    • Organ dysfunction burden was also strongly associated with greater healthcare utilization.

    • Strengths include a nationally representative sample and survey-weighted analyses.

    • Limitations include the use of administrative coding and inability to assess laboratory values, lymphoma subtype, disease stage, or treatment details.

    • Key Finding: Increasing acute organ dysfunction burden was associated with an exponential increase in inpatient mortality among hospitalized lymphoma patients, reaching nearly a 92-fold increase with three or more dysfunctions (OR 91.70).

    
    
    

    • Acute organ dysfunction burden provides a practical method for inpatient risk stratification.

    • Early recognition of organ dysfunction may facilitate prompt escalation of care.

    • Preventing progression to multiple organ dysfunction may improve survival and reduce resource utilization.

    • These findings support integrating organ dysfunction burden into clinical decision-making for hospitalized lymphoma patients.