Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy
Por:
Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Losada B, Pinto A, Custodio AB, Muñoz MDM, Gómez-Mediavilla J, Torregrosa MD, Cruz P, Higuera O and Molina-Garrido MJ
Publicada:
1 mar 2021
Ahead of Print:
22 mar 2021
Resumen:
Simple Summary
Unplanned hospitalizations (UHs) are common among elderly patients with cancer who receive chemotherapy. This fact decreases quality of life or performance status and increases health costs. Our objective was to determine predictive factors for UH in this population. A score based on six variables taken from geriatric assessment and chemotherapy characteristics was developed in a series of 493 elderly patients receiving chemotherapy. The use of this score may reliably identify patients at risk for UH, thus helping to plan treatment, implement adaptive measures, and set up a close follow-up schedule.
Purpose: To determine the incidence of unplanned hospitalization (UH) and to identify risk factors for UH in elderly patients with cancer who start chemotherapy. Methods: In all, 493 patients over 70 years starting new chemotherapy regimens were prospectively included. A pre-chemotherapy geriatric assessment was performed, and tumor and treatment variables were collected. The association between these factors and UH was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 37% of patients had at least one episode of UH. Risk factors were the use of combination chemotherapy at standard doses, a MAX2 index >= 1, a Charlson comorbidity score >= 2, albumin level <3.5 g/dL, falls in the past 6 months >= 1, and weight loss >5%. Three risk groups for UH were established according to the score in all patients: 0-1: 17.5%; 2: 34%; and 3-7: 57% (p < 0.001). The area under receiver operation characteristic (ROC) curve was 0.72 (95% CI: 0.67-0.77). Conclusion: This simple tool can help to reduce the incidence of UH in elderly patients with cancer who are scheduled to initiate chemotherapy treatment.
Filiaciones:
Feliu J:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Espinosa E:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Basterretxea L:
Oncology Department, Hospital Universitario de Donostia, 20014 Donostia, Spain
:
Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain
Llabrés E:
Oncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, Spain
Jiménez-Munárriz B:
Oncology Department, Centro Integral Oncológico Clara Campal, 28050 Madrid, Spain
Losada B:
Oncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, Spain
Pinto A:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Custodio AB:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Muñoz MDM:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
Gómez-Mediavilla J:
Oncology Department, Hospital Universitario de Donostia, 20014 Donostia, Spain
:
Oncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, Spain
Cruz P:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Higuera O:
Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, Spain
Molina-Garrido MJ:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
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