TY - JOUR
T1 - Acute Hospital Encounters in Cancer Patients Treated With Definitive Radiation Therapy
AU - Marar, Mallika
AU - Gabriel, Peter
AU - Hwang, Wei Ting
AU - Owen, Daniel R.
AU - Ju, Melody
AU - Simone, Charles B.
AU - Christodouleas, John
AU - Vapiwala, Neha
AU - Berman, Abigail T.
N1 - Publisher Copyright:
© 2018 Elsevier Inc.
PY - 2018/7/15
Y1 - 2018/7/15
N2 - Purpose: 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. Methods and Materials: 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. Results: 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%). Conclusions: 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.
AB - Purpose: 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. Methods and Materials: 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. Results: 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%). Conclusions: 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.
KW - Antineoplastic Agents/therapeutic use
KW - Cancer Care Facilities/statistics & numerical data
KW - Central Nervous System Neoplasms/radiotherapy
KW - Emergency Service, Hospital/statistics & numerical data
KW - Hospitalization/statistics & numerical data
KW - Humans
KW - Neoplasms/drug therapy
KW - Odds Ratio
KW - Patient Discharge/statistics & numerical data
KW - Pennsylvania
KW - Radiotherapy/statistics & numerical data
KW - Retrospective Studies
KW - Time Factors
UR - http://www.scopus.com/inward/record.url?scp=85048799562&partnerID=8YFLogxK
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=purepublist2023&SrcAuth=WosAPI&KeyUT=WOS:000436809700030&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1016/j.ijrobp.2018.04.025
DO - 10.1016/j.ijrobp.2018.04.025
M3 - Article
C2 - 29976506
SN - 0360-3016
VL - 101
SP - 935
EP - 944
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 4
ER -
