Registered Dietitian Nutritionists Impact on Unplanned Hospital Admissions and Treatment Completion Rates for Ambulatory Cancer Patients

Abstract Background Home hospitalization at the end of life can sometimes be perturbed by unplanned hospital admissions (UHAs, defined as any admission that is not part of a preplanned care procedure), which increase the likelihood of death in hospital. The objectives were to describe the occurrence and causes of UHAs in cancer patients receiving end-of-life care at home, and to identify factors associated with UHAs and death in hospital. Methods A retrospective, single-center study (performed at a regional cancer center in the city of Lille, northern France) of advanced cancer patients discharged to home hospitalization between January 2014 and December 2017. We estimated the incidence of UHA over time using Kaplan-Meier method and Kalbfleish and Prentice method. We investigated factors associated with the risk UHA in cause-specific Cox models. We evaluated factors associated with death in hospital in logistic regressions. Results One hundred and forty-two patients were included in the study. Eighty-two patients (57.7 %) experienced one or more UHAs, a high proportion of which occurred within 1 month after discharge to home. Most UHAs were related to physical symptoms and were initiated by the patient’s family physician. A post-discharge palliative care consultation was associated with a significantly lower incidence of UHAs. Sixty-five patients (47.8 % of the deaths) died in hospital. In a multivariate analysis, living alone and the presence of one or more children at home were associated with death in hospital. Conclusions More than 40 % of cancer patients receiving end of life home hospitalization were not readmitted to hospital, reflecting the effectiveness of this type of palliative care setting. However, over half of the UHAs were due to an acute intercurrent event. Our results suggest that more efforts should be focused on anticipating these events at home – primarily via better upstream coordination between hospital physicians and family physicians.

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Weight Loss Associated with Platinum-Based Chemotherapy in Patients with Advanced Lung Cancer

Chemotherapy ◽

10.1159/000443983 ◽

2016 ◽

Vol 61 (5) ◽

pp. 256-261 ◽

Cited By ~ 4

Author(s):

Kayoko Morio ◽

Toshiyuki Minami ◽

Takashi Sozu ◽

Kazuyuki Niki ◽

Takashi Kijima ◽

...

Keyword(s):

Lung Cancer ◽

Weight Loss ◽

Cancer Patients ◽

Therapeutic Effect ◽

Treatment Completion ◽

Advanced Lung Cancer ◽

Completion Rates ◽

Lung Cancer Patients ◽

Platinum Based Chemotherapy ◽

Grade 3

Background: We examined whether the weight loss that occurs with platinum-based chemotherapy in lung cancer patients is associated with chemotherapy side effects, treatment completion rates and therapeutic effect. Methods: We retrospectively reviewed charts of advanced lung cancer patients treated with ≥2 cycles of platinum-based chemotherapy. Patients were divided into 2 groups based on ≥5 or <5% weight loss. Relationships between weight loss and other variables were investigated. Results: Among 114 patients, 18 (15.8%) experienced ≥5% weight loss. Significantly more patients with small-cell lung cancer (SCLC) than with non-SCLC were found to have ≥5% weight loss (30.8 vs. 11.4%, p = 0.023). Patients with ≥5% weight loss experienced higher incidences of grade 3-4 leukopenia (p = 0.008) and neutropenia (p = 0.005), and treatment completion rates were lower in this group (p = 0.035). Weight loss was not significantly associated with therapeutic effect. Conclusion: The weight loss in patients with advanced lung cancer receiving platinum-based chemotherapy is associated with SCLC, grade 3-4 leukopenia, neutropenia and a decrease in treatment completion rate.

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Unplanned hospital admissions in breast cancer patients undergoing chemotherapy

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2013.07.215 ◽

2013 ◽

Vol 39 (11) ◽

pp. S71

Author(s):

Xiaokun Zou ◽

Mei-Lin Ah-See ◽

Duraisamy Ravichandran

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Hospital Admissions ◽

Breast Cancer Patients ◽

Unplanned Hospital Admissions

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The Perceptions of Cancer Patients Regarding the Causes and Preventability of Unplanned Hospital Admissions

American Journal of Clinical Oncology ◽

10.1097/coc.0000000000000739 ◽

2020 ◽

Vol 43 (10) ◽

pp. 734-740

Author(s):

Barry R. Meisenberg ◽

Mitchell Karpman ◽

Jessica Tan ◽

Stephanie Parlacoski ◽

Jane Rhule ◽

...

Keyword(s):

Cancer Patients ◽

Hospital Admissions ◽

Unplanned Hospital Admissions

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Comparison of Cancer Patients to Non-Cancer Patients among COVID-19 Inpatients at a National Level

Cancers ◽

10.3390/cancers13061436 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1436

Author(s):

Alain Bernard ◽

Jonathan Cottenet ◽

Philippe Bonniaud ◽

Lionel Piroth ◽

Patrick Arveux ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Mortality Risk ◽

Hospital Admissions ◽

National Level ◽

Administrative Database ◽

Hospital Death ◽

Solid Cancer ◽

Hematological Cancer ◽

Risk Of Death

(1) Background: Several smaller studies have shown that COVID-19 patients with cancer are at a significantly higher risk of death. Our objective was to compare patients hospitalized for COVID-19 with cancer to those without cancer using national data and to study the effect of cancer on the risk of hospital death and intensive care unit (ICU) admission. (2) Methods: All patients hospitalized in France for COVID-19 in March–April 2020 were included from the French national administrative database, which contains discharge summaries for all hospital admissions in France. Cancer patients were identified within this population. The effect of cancer was estimated with logistic regression, adjusting for age, sex and comorbidities. (3) Results: Among the 89,530 COVID-19 patients, we identified 6201 cancer patients (6.9%). These patients were older and were more likely to be men and to have complications (acute respiratory and kidney failure, venous thrombosis, atrial fibrillation) than those without cancer. In patients with hematological cancer, admission to ICU was significantly more frequent (24.8%) than patients without cancer (16.4%) (p < 0.01). Solid cancer patients without metastasis had a significantly higher mortality risk than patients without cancer (aOR = 1.4 [1.3–1.5]), and the difference was even more marked for metastatic solid cancer patients (aOR = 3.6 [3.2–4.0]). Compared to patients with colorectal cancer, patients with lung cancer, digestive cancer (excluding colorectal cancer) and hematological cancer had a higher mortality risk (aOR = 2.0 [1.6–2.6], 1.6 [1.3–2.1] and 1.4 [1.1–1.8], respectively). (4) Conclusions: This study shows that, in France, patients with COVID-19 and cancer have a two-fold risk of death when compared to COVID-19 patients without cancer. We suggest the need to reorganize facilities to prevent the contamination of patients being treated for cancer, similar to what is already being done in some countries.

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