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Introduction: Retrospective studies have suggested that patients with poor performance status treated with immune checkpoint inhibitors have shorter overall survival and poorer response rates. This study was undertaken to investigate the possible relationships between inpatient immune checkpoint inhibitor use and clinical outcomes. Methods: This was a retrospective chart review of cancer patients who received an immune checkpoint inhibitor while hospitalized from 1 January 2016 to 30 December 2020. The primary outcome was 90-day mortality or admission to hospice rate. Secondary outcomes included overall survival, time to death or discharge to hospice, and descriptive summarization of patient characteristics. Results: A total of 52 patients were analyzed. At 90 days, 68.2% of subjects were expired or admitted to hospice (95% CI: 54.7–81%). 90-day overall survival was 47.1%; median survival time was 81 days (95% CI: 28–242 days). The median time to death or hospice was 35 days (95% CI: 24–72 days). The time to death or hospice was shorter for immune checkpoint inhibitor-naive patients compared to those who received immune checkpoint inhibitors prior to admission (29 days, 95% CI: 12–43 days vs. 242 days, 95% CI: 36–1288 days, respectively; HR: 2.74, 95% CI: 1.2–6.25; p = 0.0121). No differences were found when comparing other baseline characteristics. Conclusion: A majority of patients who received an immune checkpoint inhibitor while hospitalized were either discharged to hospice or expired by 90 days. An increased rate of death or discharge to hospice was observed for patients who were immune checkpoint inhibitor-naive prior to their admission. [ABSTRACT FROM AUTHOR]

Background: Electronic health records (EHRs) may help enable reliable, rapid data management for many uses, such as facilitating communication of advance care planning (ACP). However, issues with validity and accuracy of EHRs hinder the use of ACP information for practical applications. Design: We present a cross-sectional pilot study of 433 older adults with cancer from three large health care systems, participating in an ongoing multisite pragmatic trial (4UH3AG060626-02). We compared data extracted from dedicated structured EHR fields for ACP to a chart review of corresponding ACP documentation contained in the medical chart. Results: Structured ACP data existed for 43.2% of patients and varied by site (25.7% −48.9%). Of the identified structured ACP data elements, 59.2% of recorded elements were correct, 23.7% were incorrect, and 17.1% were duplicates with heterogeneity across sites. Conclusion: Structured ACP data in EHRs were frequently incorrect. This represents a problem for patients and their families, as well as quality improvement and research efforts. Clinical Trials Registration: NCT03609177. [ABSTRACT FROM AUTHOR]

t is estimated that 80 percent of patients who undergo high-dose chemotherapy prior to transplantation develop mucositis. Mucositis is a painful complication, which can lead to poor nutrition, increased use of narcotics, dehydration, greater risk for infection and bacteremia and altered quality of life. Patients can have oral ulceration, epigastric discomfort, diarrhea, rectal irritation and bleeding. It is likely that the complications of mucositis can contribute to increased length of stay during stem cell transplantation. The purpose of this study is to compare patients who received Kepivance ® (palifermin) with patients that did not receive this medication regimen during autologous stem cell transplantation. We performed a retrospective analysis of 40 patients; 20 prior to the institution of Kepivance ® (palifermin), and 20 patients after. The objective of this study was to determine whether the use of Kepivance decreases the incidence and duration of mucositis. A retrospective comparison study is appropriate for this research. Data for this study was taken from forty discharged inpatient medical records. No patient identifiers were used, instead a number for each group from 1 to 20 was given. The data collection tool was approved by the Institutional Review Board. A descriptive statistical analysis was performed by an independent statistician. The data points extracted were the following: diagnosis, length of stay, oral mucositis, GI mucositis, narcotics, TPN, antifungals, antidiarrheals and antibiotic use. The findings of this study support the clinical decision to include Kepivance® (palifermin)in the preventive treatment for mucositis in Autologous BMT/Stem Cell Transplant Patients. The average length of stay for non-Kepivance patients was 32.3 days compared to 28.3 days in patients who received the drug. The severity of both oral and GI mucositis appeared to be less. 17 out of 20 non-Kepivance patients experienced diarrhea or rectal irritation versus 9 out of 20 with Kepivance. There was a trend toward earlier engraftment in the Kepivance group. This pilot study suggests an improvement in mucositis symptoms with the use of Kepivance® (palifermin). It appears that mucositis and its treatment contribute to the length of stay and costs of stem cell transplantation. Quality of life for these patients can be greatly improved if mucositis is eliminated or reduced during the course of stem cell transplantation. [ABSTRACT FROM AUTHOR]