scholarly journals MA12.07 Oncological Procedures and Risk Assessment of COVID-19 in Thoracic Cancer Patients: A Picture From an Italian Cancer Center

2021 ◽  
Vol 16 (10) ◽  
pp. S923-S924
Author(s):  
M. Bungaro ◽  
V. Bertaglia ◽  
M. Audisio ◽  
E. Parlagreco ◽  
C. Pisano ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cancer Patients ◽  
Cancer Center ◽  
Thoracic Cancer

Practice of venous thromboembolism (VTE) prophylaxis in hospitalized cancer patients at a comprehensive cancer center.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 149-149
Author(s):  
M.Alma Rodriguez ◽  
Alma Yvette DeJesus ◽  
Lee Cheng ◽  
Michael Kroll
Keyword(s):  
Risk Assessment ◽  
Cancer Patients ◽  
Comprehensive Cancer Center ◽  
Categorical Variables ◽  
Cancer Center ◽  
Moderate Risk ◽  
Pharmacological Prophylaxis ◽  
Vte Prophylaxis ◽  
National Quality ◽  
The Impact

149 Background: VTE prophylaxis measures are endorsed by the National Quality Forum in alignment with quality indicators from the Centers for Medicare & Medicaid Services. Accordingly, documentation of VTE risk, prophylaxis measures, and contraindications are recommended for hospitalized patients. To standardize practice we embedded a VTE risk assessment and prophylaxis module into admission and post-surgical order sets (OS), starting August 15, 2011. Methods: A retrospective study of 9,065 cancer patients (≥18 years) admitted to The University of Texas MD Anderson Cancer Center between June 01, 2013 through September 30, 2013. Pharmacological prophylaxis was executed with low-molecular-weight heparin or unfractionated heparin. Mechanical prophylaxis was executed with graduated compression stockings and/or sequential compression devices. Chi-square testing was used to determine the association between categorical variables. All statistically significant levels were determined with P values < 0.05. Results: 7,366 (81%) of all hospital admissions had documented VTE risk assessment and prophylaxis through the standardized VTE module. Before implementation of the new OS, only 40% of eligible patients received an order for VTE prophylaxis. The majority of patients were designated high or moderate risk (91.1%). Patients with high risk were more likely to receive pharmacological prophylaxis than those with moderate risk (74.1% vs. 38.2%, P<0.01). The most frequent contraindications to pharmacological prophylaxis were major surgery with risk of bleeding and thrombocytopenia (Table). Conclusions: Most patients received VTE prophylaxis based on VTE risk levels presented in a standardized OS. There is is limited information in the clinical literature about the impact of VTE prophylaxis on outcomes among cancer patients, we plan to assess anticoagulation-related outcomes in this cohort of patients. [Table: see text]

Using the Risk Assessment Index (RAI) to predict 90-day mortality and hospital utilization in cancer patients at UPMC Hillman Cancer Center.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 243-243
Author(s):  
Christine Ann Garcia ◽  
Jeffrey Borrebach ◽  
Stefanie C Altieri Dunn ◽  
Johanna E Bellon ◽  
Ellen Ormond ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cancer Patients ◽  
Hospital Admissions ◽  
Hospital Utilization ◽  
Cancer Center ◽  
Mortality Data ◽  
Cancer Type ◽  
Assessment Index ◽  
Significant Difference ◽  
Ed Visits

243 Background: Patients with cancer vary considerably in health status and functional reserve. Identifying the most frail patients whom are at risk of treatment toxicity or death can be difficult. The Risk Assessment Index (RAI) is a validated tool used to assess frailty in patients prior to surgery. Thus, we aimed to investigate frailty assessment utilizing the RAI in cancer patients and its ability to predict hospital utilization and 90-day mortality. Methods: From 9/15/2017 to 1/31/2018, new patients with solid tumor malignancies at the UPMC Hillman Cancer Center completed the RAI. Age, cancer type and stage, and treatments were abstracted. ED visits, hospitalizations and mortality data were provided by the Wolff Center at UPMC. Mann-Whitney U and likelihood-ratio tests were performed comparing RAI, ED usage/hospitalizations, and mortality. Elective hospital admissions were excluded. Results: 273 patients completed the RAI. 58.6% of pts were male and average age was 62.7 (21-88), and the average RAI score was 39.9 (IQR 35-44). The most common cancer types were melanoma (22.7%), prostate (14.3%), and lung (11.4%). 43.6% of patients had stage IV cancer. Within 90 days after RAI, 51 patients (18.7%) experienced at least one unplanned ED visit or hospitalization, and 10 patients (3.7%) were deceased. Patients with an ED visit/hospitalization had an average RAI of 42 (IQR 37-46) compared to 39.4 (IQR 35-43) for patients without one: a 2.6-point difference (p = 0.008). 90-day mortalities had an average RAI score of 47.5 (IQR 42-53) compared to 39.6 (IQR 35-44) for non-mortalities: a 7.9-point difference (p = 0.003). Six of 242 (2.5%) patients without a hospitalization experienced mortality whereas 4 of 31 (12.9%) patients with a hospitalization experienced mortality (p = 0.017). Conclusions: This study shows that the RAI may be utilized to predict 90-day mortality in cancer patients. Patients at greatest risk of 90-day mortality were more likely to have unplanned hospitalizations. While there was a statistically significant difference in RAI scores between patients with and without unplanned ED visits/hospitalizations, this difference was too small to be clinically meaningful.

VTE risk assessment in cancer

2016 ◽  
Vol 07 (01) ◽  
pp. 20-25
Author(s):  
I. Pabinger ◽  
C. Ay
Keyword(s):  
Risk Assessment ◽  
Cancer Patients ◽  
Medical Oncology ◽  
Clinical Importance ◽  
Cancer Surgery ◽  
Ambulatory Setting ◽  
Oncology Patients ◽  
Related Factors ◽  
Risk Assessment Models ◽  
Increased Risk

SummaryVenous thromboembolism (VTE) in patients with cancer is associated with an increased morbidity and mortality, and its prevention is of major clinical importance. However, the VTE rates in the cancer population vary between 0.5% - 20%, depending on cancer-, treatment- and patient-related factors. The most important contributors to VTE risk are the tumor entity, stage and certain anticancer treatments. Cancer surgery represents a strong risk factor for VTE, and medical oncology patients are at increased risk of developing VTE, especially when receiving chemotherapy or immunomodulatory drugs. Also biomarkers have been investigated for their usefulness to predict risk of VTE (e.g. elevated leukocyte and platelet counts, soluble P-selectin, D-dimer, etc.). In order to identify cancer patients at high risk of VTE and to improve risk stratification, risk assessment models have been developed, which contain both clinical parameters and biomarkers. While primary thromboprophylaxis with lowmolecular- weight-heparin (LMWH) is recommended postoperatively for a period of up to 4 weeks after major cancer surgery, the evidence is less clear for medical oncology patients. Thromboprophylaxis in hospitalized medical oncology patients is advocated, and is based on results of randomized controlled trials which evaluated the efficacy and safety of LMWH for prevention of VTE in hospitalized medically ill patients. In recent trials the benefit of primary thromboprophylaxis in cancer patients receiving chemotherapy in the ambulatory setting has been investigated. However, at the present stage primary thromboprophylaxis for prevention of VTE in these patients is still a matter of debate and cannot be recommended for all cancer outpatients.

Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ quality of life: An Arabic version of the Functional Living Index-Emesis

2021 ◽  
pp. 107815522199844
Author(s):  
Abdullah M Alhammad ◽  
Nora Alkhudair ◽  
Rawan Alzaidi ◽  
Latifa S Almosabhi ◽  
Mohammad H Aljawadi
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Arabic Language ◽  
Nausea And Vomiting ◽  
Cancer Center ◽  
Arabic Version ◽  
Patient Reported ◽  
Arabic Speaking ◽  
The Impact

Introduction Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients’ quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients’ quality of life. Methods Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. Results One-hundred cancer patients who received chemotherapy were enrolled. The participants’ mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). Conclusions The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

scholarly journals Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cancer Patients ◽  
Medical Center ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cam Use ◽  
Complementary And Alternative

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

scholarly journals Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanghee Lee ◽  
Yoon Jung Chang ◽  
Hyunsoon Cho
Keyword(s):  
Risk Assessment ◽  
Health Insurance ◽  
Cancer Patients ◽  
National Health Insurance ◽  
National Health ◽  
Cancer Mortality ◽  
Prediction Models ◽  
Assessment Methods ◽  
Chronic Obstructive ◽  
Mortality Risks

Abstract Background Cancer patients’ prognoses are complicated by comorbidities. Prognostic prediction models with inappropriate comorbidity adjustments yield biased survival estimates. However, an appropriate claims-based comorbidity risk assessment method remains unclear. This study aimed to compare methods used to capture comorbidities from claims data and predict non-cancer mortality risks among cancer patients. Methods Data were obtained from the National Health Insurance Service-National Sample Cohort database in Korea; 2979 cancer patients diagnosed in 2006 were considered. Claims-based Charlson Comorbidity Index was evaluated according to the various assessment methods: different periods in washout window, lookback, and claim types. The prevalence of comorbidities and associated non-cancer mortality risks were compared. The Cox proportional hazards models considering left-truncation were used to estimate the non-cancer mortality risks. Results The prevalence of peptic ulcer, the most common comorbidity, ranged from 1.5 to 31.0%, and the proportion of patients with ≥1 comorbidity ranged from 4.5 to 58.4%, depending on the assessment methods. Outpatient claims captured 96.9% of patients with chronic obstructive pulmonary disease; however, they captured only 65.2% of patients with myocardial infarction. The different assessment methods affected non-cancer mortality risks; for example, the hazard ratios for patients with moderate comorbidity (CCI 3–4) varied from 1.0 (95% CI: 0.6–1.6) to 5.0 (95% CI: 2.7–9.3). Inpatient claims resulted in relatively higher estimates reflective of disease severity. Conclusions The prevalence of comorbidities and associated non-cancer mortality risks varied considerably by the assessment methods. Researchers should understand the complexity of comorbidity assessments in claims-based risk assessment and select an optimal approach.

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