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Acute Hospital Encounters in Cancer Patients Treated With Definitive Radiation Therapy.

Authors :
Marar, Mallika
Gabriel, Peter
Hwang, Wei-Ting
Owen, Daniel R.
Ju, Melody
Iisimone, Charles B.
Christodouleas, John
Vapiwala, Neha
Berman, Abigail T.
Simone, Charles B 2nd
Source :
International Journal of Radiation Oncology, Biology, Physics. Jul2018, Vol. 101 Issue 4, p935-944. 10p.
Publication Year :
2018

Abstract

<bold>Purpose: </bold>Acute hospital encounters in patients undergoing curative-intent radiation therapy (RT) have not previously been well characterized. Understanding acute visit patterns among RT patients yields insights for risk assessments and cancer urgent care clinics that could decrease hospitalization rates and reduce health care costs. This study aims to identify patient, disease-site, and treatment characteristics associated with emergency department visits and inpatient admissions in cancer patients treated with definitive RT.<bold>Methods and Materials: </bold>A retrospective cohort study was conducted using data from a quaternary-care cancer center. The cohort was defined as all consecutive patients aged ≥ 18 years who began RT between July 1, 2011, and December 31, 2013; were without metastases; and were treated with curative intent. An acute encounter was defined as an emergency department visit or inpatient admission during RT or within 30 days after the conclusion of RT.<bold>Results: </bold>Among 1852 unique RT courses, 666 RT courses (36.0%) involved at least 1 acute encounter, and a total of 1418 acute encounters were identified. RT courses with at least 1 acute encounter corresponded to patients more likely to be on their second (odds ratio [OR], 1.96; P < .001) or third (OR, 3.82; P < .05) RT course and undergoing concurrent chemotherapy (OR, 6.38; P < .001). Among the RT courses with at least 1 acute encounter, the most common disease site was thoracic (22.8%), followed by head and/or neck (22.2%) and gastrointestinal (18.3%). Central nervous system tumors had the greatest proportion of RT courses with acute encounters (77.1%).<bold>Conclusions: </bold>In this retrospective analysis, more than one-third of curative-intent RT courses were associated with at least 1 acute hospital encounter during or shortly after irradiation. Given that acute encounters varied by patient, disease-site, and treatment characteristics, these findings can inform targeted preventive measures to reduce cancer-related acute hospital encounters and guide improved management protocols. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03603016
Volume :
101
Issue :
4
Database :
Academic Search Index
Journal :
International Journal of Radiation Oncology, Biology, Physics
Publication Type :
Academic Journal
Accession number :
130262348
Full Text :
https://doi.org/10.1016/j.ijrobp.2018.04.025