One-Fifth of Hospitalizations in Advanced GI Cancer Avoidable
Higher 90-day mortality seen after avoidable versus non-avoidable hospitalizations
FRIDAY, Jan. 17, 2014 (HealthDay News) -- For patients with advanced gastrointestinal (GI) cancer, about 20 percent of hospitalizations are potentially avoidable, according to a study published online Jan. 13 in the Journal of Clinical Oncology.
Gabriel A. Brooks, M.D., and colleagues from the Dana-Farber Cancer Institute in Boston, and colleagues conducted a retrospective study to identify and characterize potentially avoidable hospitalization in patients with GI malignancies. A total of 201 hospitalizations were included for 154 unique patients (median age, 62 years) admitted to an inpatient medical oncology or palliative care service between December 2011 and July 2012.
The researchers found that the most common diagnosis was colorectal cancer (32 percent) and that most hospitalized patients (81 percent) had metastatic disease. More than half of hospitalizations (53 percent) were due to cancer symptoms and more than one-quarter (28 percent) were due to cancer treatment complications. Nineteen percent of hospitalizations were considered potentially avoidable by medical oncologists. Potentially avoidable hospitalizations were more likely among patients aged ≥70 years (odds ratio [OR], 2.63); those who had received advice from an oncologist to consider hospice (OR, 6.09); and those who had received three or more lines of chemotherapy (OR, 2.68). Higher 90-day mortality was observed after avoidable hospitalizations versus non-avoidable hospitalizations (OR, 6.4).
"Potentially avoidable hospitalizations are common in patients with advanced GI cancer," the authors write. "The majority of potentially avoidable hospitalizations occurred in patients with advanced treatment-refractory cancers near the end of life."
Abstract (http://jco.ascopubs.org/content/early/2014/01/13/JCO.2013.52.4330.abstract )Full Text (http://jco.ascopubs.org/content/early/2014/01/13/JCO.2013.52.4330.full.pdf+html )