Unplanned hospitalizations are common among older adults with gastrointestinal cancers, especially in the first few months after surgery or chemotherapy.
About 60% experienced at least one unplanned admission, most often for fluid and electrolyte disorders, intestinal obstruction, or pneumonia, Dr. Joanna-Grace M. Manzano and her associates reported (J. Clin. Oncol. 2014 Oct. 6 [doi:10.1200/JCO.2014.55.3131]).
A number of demographic and clinical characteristics increased the risk of such admissions, including black race, low socioeconomic status, dual Medicare/Medicaid eligibility, multiple comorbidities, and advanced disease, said Dr. Manzano of the University of Texas MD Anderson Cancer Center, Houston, and her coauthors. Patients with pancreatic, gastric, and esophageal cancers were especially at risk, they noted.
The team reviewed the medical claims of 30,199 patients older than 66 years who had a diagnosis of gastrointestinal cancer. The mean observation time was 15 months. Among these, there were 60,837 claims; more than half of those were for unplanned hospitalizations. The mean time to first admission was about 2 months after oncologic treatment.
Of those who had such a hospitalization, 19% had undergone chemotherapy, radiotherapy, or a surgical procedure in the prior 30 days. In addition, 9% had visited an emergency department.
Understanding these risk factors could help clinicians keep a preemptive eye out for problems. “Knowing who is at risk for an unplanned hospitalization also opens up opportunities for
anticipatory guidance and patient education during the active phase of treatment,” the investigators wrote.
The authors had no financial disclosures.
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