Disseminated intravascular coagulation (DIC) is an uncommon but severe hematologic complication in multiple myeloma (MM). Its impact on in-hospital mortality, clinical complications, and resource utilization remains poorly characterized at a national level. 

We aimed to compare outcomes of hospitalized MM patients with and without DIC using a National Inpatient Sample (NIS) database.

Data Source: Cross-sectional analysis of the 2018–2021 NIS, incorporating discharge weights to generate nationally representative estimates.

Study Cohort: Adult hospitalizations (age ≥18 years) with a primary or secondary diagnosis of multiple myeloma (ICD-10-CM C90.0) were identified and stratified by DIC status (D65).

Outcomes: Primary outcomes were in-hospital mortality, LOS, and inflation-adjusted hospital charges. Secondary outcomes included major organ complications, thrombotic and bleeding events, shock, and non-home discharge.

Adjusted Analysis: Survey-weighted regression models adjusted for demographics, admission and hospital characteristics, and relevant comorbidities. Logistic regression was used for binary outcomes and linear regression for continuous outcomes.

Statistical Reporting: Categorical and continuous variables were compared using design-based tests. Results were reported as adjusted odds ratios or β coefficients with 95% CIs. Analyses were performed in R 4.5.0 using the survey package.

 MM patients with DIC experienced markedly worse inpatient outcomes and significantly greater resource utilization compared with those without DIC, highlighting DIC as a critical prognostic marker in MM hospitalizations and underscoring the need for early recognition and aggressive multidisciplinary management.