Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy
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 a...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/13/6/1437 |
| _version_ | 1797540512538820608 |
|---|---|
| author | Jaime Feliu Enrique Espinosa Laura Basterretxea Irene Paredero Elisenda Llabrés Beatriz Jiménez-Munárriz Beatriz Losada Alvaro Pinto Ana Belén Custodio María del Mar Muñoz Jeniffer Gómez-Mediavilla María Dolores Torregrosa Patricia Cruz Oliver Higuera María José Molina-Garrido |
| author_facet | Jaime Feliu Enrique Espinosa Laura Basterretxea Irene Paredero Elisenda Llabrés Beatriz Jiménez-Munárriz Beatriz Losada Alvaro Pinto Ana Belén Custodio María del Mar Muñoz Jeniffer Gómez-Mediavilla María Dolores Torregrosa Patricia Cruz Oliver Higuera María José Molina-Garrido |
| author_sort | Jaime Feliu |
| collection | DOAJ |
| description | 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% (<i>p</i> < 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. |
| first_indexed | 2024-03-10T13:02:18Z |
| format | Article |
| id | doaj.art-b8bb6de168d84439ab04703932ab8183 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T13:02:18Z |
| publishDate | 2021-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b8bb6de168d84439ab04703932ab81832023-11-21T11:27:22ZengMDPI AGCancers2072-66942021-03-01136143710.3390/cancers13061437Prediction of Unplanned Hospitalizations in Older Patients Treated with ChemotherapyJaime Feliu0Enrique Espinosa1Laura Basterretxea2Irene Paredero3Elisenda Llabrés4Beatriz Jiménez-Munárriz5Beatriz Losada6Alvaro Pinto7Ana Belén Custodio8María del Mar Muñoz9Jeniffer Gómez-Mediavilla10María Dolores Torregrosa11Patricia Cruz12Oliver Higuera13María José Molina-Garrido14Oncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Universitario de Donostia, 20014 Donostia, SpainOncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, SpainOncology Department, Hospital Universitario Insular de Gran Canarias, 35016 Las Palmas, SpainOncology Department, Centro Integral Oncológico Clara Campal, 28050 Madrid, SpainOncology Department, Hospital Universitario de Fuenlabrada, 28942 Fuenlabrada, SpainOncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Virgen de la Luz, 16002 Cuenca, SpainOncology Department, Hospital Universitario de Donostia, 20014 Donostia, SpainOncology Department, Hospital Universitario Dr. Peset, 46017 Valencia, SpainOncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Universitario La Paz. IDIPAZ, Cátedra UAM-AMGEN, Centro de Investigación Biomédica en Red de Cáncer, 28046 Madrid, SpainOncology Department, Hospital Virgen de la Luz, 16002 Cuenca, SpainPurpose: 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% (<i>p</i> < 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.https://www.mdpi.com/2072-6694/13/6/1437older patientunplanned hospitalizationsrisk scoregeriatric assessmentchemotherapy |
| spellingShingle | Jaime Feliu Enrique Espinosa Laura Basterretxea Irene Paredero Elisenda Llabrés Beatriz Jiménez-Munárriz Beatriz Losada Alvaro Pinto Ana Belén Custodio María del Mar Muñoz Jeniffer Gómez-Mediavilla María Dolores Torregrosa Patricia Cruz Oliver Higuera María José Molina-Garrido Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy Cancers older patient unplanned hospitalizations risk score geriatric assessment chemotherapy |
| title | Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy |
| title_full | Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy |
| title_fullStr | Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy |
| title_full_unstemmed | Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy |
| title_short | Prediction of Unplanned Hospitalizations in Older Patients Treated with Chemotherapy |
| title_sort | prediction of unplanned hospitalizations in older patients treated with chemotherapy |
| topic | older patient unplanned hospitalizations risk score geriatric assessment chemotherapy |
| url | https://www.mdpi.com/2072-6694/13/6/1437 |
| work_keys_str_mv | AT jaimefeliu predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT enriqueespinosa predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT laurabasterretxea predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT ireneparedero predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT elisendallabres predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT beatrizjimenezmunarriz predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT beatrizlosada predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT alvaropinto predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT anabelencustodio predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT mariadelmarmunoz predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT jeniffergomezmediavilla predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT mariadolorestorregrosa predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT patriciacruz predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT oliverhiguera predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy AT mariajosemolinagarrido predictionofunplannedhospitalizationsinolderpatientstreatedwithchemotherapy |