scholarly journals 76. THE ROLE OF FRAILTY IN PREDICTING POSTOPERATIVE SOCIOECONOMIC OUTCOMES AMONG PATIENTS WITH METASTATIC BRAIN CANCER

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii16-ii16
Author(s):  
Adham M Khalafallah ◽  
Adrian E Jimenez ◽  
Sakibul Huq ◽  
Palak Patel ◽  
Debraj Mukherjee
Keyword(s):  
Cancer Patients ◽  
Brain Cancer ◽  
Metastatic Cancer ◽  
Frailty Index ◽  
Primary Lung Cancer ◽  
Hospital Charges ◽  
Metastatic Tumors ◽  
Total Hospital ◽  
Discharge Disposition ◽  
Significant Difference

Abstract BACKGROUND Patient frailty is an important consideration in the context of providing high-value, cost-effective care, as it has shown to effectively predict postoperative morbidity and mortality in many surgical subspecialties. However, for metastatic cancer patients, there is a lack of consensus as to whether frailty effectively predicts postoperative outcomes such as survival and length of stay (LOS), specifically among patients with metastatic brain tumors. OBJECTIVE The present study sought to determine if the 5-factor modified frailty index (mFI-5) independently predicts LOS, discharge disposition, and total hospital charges among patients with metastatic brain cancer. METHODS Patients diagnosed with metastatic brain cancer who underwent surgery between 2017–2019 at a single academic institution were analyzed. Bivariate analysis identified patient characteristics significantly associated of LOS, discharge disposition, and total hospital charges. Multivariate linear regression was used to identify independent predictors of LOS and total hospital charges, while multivariate logistic regression was used to identify independent predictors of non-routine discharge disposition. P <0.05 was considered statistically significant. RESULTS A total of 302 patients were included in our analysis. Our patient cohort had a mean age (standard deviation) of 62.27 11.86 years, and was majority female (52.0%) and Caucasian (74.2%). The majority of patients had a primary lung cancer (24.8%), followed by breast cancer (13.6%). There was no significant difference in mFI-5 score between patients with metastatic tumors of known origin compared to patients with metastatic tumors of unknown origin (p=0.61). In multivariate analysis, a higher mFI-5 score independently predicted longer LOS (regression coefficient [Coef]=1.36 days, p<0.001), non-routine discharge disposition (odds ratio [OR]=1.60, p=0.0079), and higher total hospital charges (Coef=$4325.54, p=0.0010). CONCLUSION The mFI-5 independently predicts LOS, discharge disposition, and total hospital charges among our cohort of metastatic brain cancer patients. Our findings may be used to aid physicians in providing high-value neurosurgical care.

A cost analysis of managing cancer-related pain among hospitalized US cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 7079-7079
Author(s):  
Olatunji B. Alese ◽  
Chao Zhang ◽  
Katerina Mary Zakka ◽  
Sungjin Kim ◽  
Christina Wu ◽  
...  
Keyword(s):  
Pain Management ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Metastatic Cancer ◽  
Hospital Charge ◽  
Hospital Charges ◽  
Total Charge ◽  
Total Hospital ◽  
Total Hospital Charge ◽  
The Cost

7079 Background: Pain is a common symptom of cancer, affecting patients' function and quality of life. It is also a common cause of hospitalization for cancer patients. The aim of this study was to evaluate the cost of in-hospital pain management among US cancer patients. Methods: A retrospective analysis of data from all US hospitals that contributed to the National Inpatient Sample for 2011-2015 was conducted. All cancer patients admitted for pain management were included in the analysis. Main outcomes were factors significantly associated with hospital length of stay, total charge per hospital stay, and in-hospital mortality. Weighted chi-square test was used for categorical covariates and univariate analysis was performed using a logistic model. Results: 122,776 patient discharges were identified. Mean age was 59.3 years and 52.3% were female. 65.9% stayed in the hospital for longer than 72 hours, with a median total hospital charge of $48,156. Conversely, the median total hospital charge for those spending less than 72 hours on admission was $15,966. Median total charge per hospital stay was similar among insured and uninsured/self-pay patients ($32,879 vs. $32,323; p=0.013), but higher in patients without metastatic disease ($33,315 vs. $29,369; p<0.001). It was also higher in those with the highest income quartile when compared with lowest income patients ($38,223 vs. $30,047; p<0.001). Co-morbid medical illnesses were more prevalent in those with longer hospital stay (15 vs. 12; p<0.001) and the overall in-hospital mortality rate was 8.2%. There was no significant difference in median total hospital charges between those who died in, or those discharged from the hospital ($33,746 vs. $32,795; p<0.001). On multivariate analyses, gender, race, insurance status, diagnosis of metastatic cancer, age, number of co-morbid medical illnesses, year of diagnosis, and median income were significant predictors of length of stay. Race, insurance payor, metastatic cancer, age, and number of co-morbid medical illnesses were significant predictors of total hospital charges, after adjusting for other covariates. Conclusions: In-patient pain management of cancer patients is associated with significant health care costs. Optimization of outpatient pain management strategies could significantly lower the cost of care for cancer.

scholarly journals The Vitamin D Receptor (VDR) Gene Polymorphisms in Turkish Brain Cancer Patients

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Bahar Toptaş ◽  
Ali Metin Kafadar ◽  
Canan Cacina ◽  
Saime Turan ◽  
Leman Melis Yurdum ◽  
...  
Keyword(s):  
Vitamin D ◽  
Cancer Patients ◽  
Vitamin D Receptor ◽  
Brain Cancer ◽  
Gene Polymorphisms ◽  
Vdr Gene ◽  
Increased Risk ◽  
Vdr Gene Polymorphisms ◽  
Significant Difference ◽  
Healthy Control

Objective. It has been stated that brain cancers are an increasingly serious issue in many parts of the world. The aim of our study was to determine a possible relationship between Vitamin D receptor (VDR) gene polymorphisms and the risk of glioma and meningioma.Methods. We investigated the VDR Taq-I and VDR Fok-I gene polymorphisms in 100 brain cancer patients (including 44 meningioma cases and 56 glioma cases) and 122 age-matched healthy control subjects. This study was performed by polymerase chain reaction-based restriction fragment length polymorphism (RF LP).Results. VDR Fok-I ff genotype was significantly increased in meningioma patients (15.9%) compared with controls (2.5%), and carriers of Fok-I ff genotype had a 6.47-fold increased risk for meningioma cases. There was no significant difference between patients and controls for VDR Taq-I genotypes and alleles.Conclusions. We suggest that VDR Fok-I genotypes might affect the development of meningioma.

scholarly journals INVESTIGATING THE EFFECT OF REFLEXOLOGY IN INTENSITY OF PAIN AND ANXIETY AMONG PATIENTS SUFFERING FROM METASTATIC CANCER IN ADULTS’ HEMATOLOGY WARD

2018 ◽  
Vol 11 (6) ◽  
pp. 401 ◽  
Author(s):  
Simin Jahani ◽  
Fatemeh Salari ◽  
Nasrin Elahi ◽  
Bahman Cheraghian
Keyword(s):  
Cancer Patients ◽  
Metastatic Cancer ◽  
Test Group ◽  
Control Group ◽  
Anxiety Management ◽  
Patients With Cancer ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
And Control

Objective: Findings suggest dissatisfaction of half of the cancer patients regarding pain and anxiety management. This study aimed to determine the effect of reflexology on the intensity of pain and anxiety among patients with metastatic cancer hospitalized inadulthematology ward.  Methods: In this study, the samples were selected from adult hematology ward in Baghaei 2 hospital in Ahwaz, Iran, according to the inclusion criteria. They were then assigned into treatment and control groups. In the treatment group, reflexology protocol was performed following manual reflexology method by Fr Josef Eugster based on Ingham method on the patient’s bed. In the control group, sole touching was used as the placebo. Reflexology was performed for three days, 30 min per day. Spielberger questionnaire were provided to the samples and completed in the first and third days, and Spielberger questionnaire was provided to the samples and completed. The data obtained from this study were then analyzed by SPSS 20.Results: The two groups did not show a significant difference in terms of demographic characteristics (p>0.05). Based on the obtained results, it was found that in the test group, there was a significant difference between the mean intensity of pain before and after the treatment across all 3 days as well as the mean anxiety of the 1st and 3rd days (p<0.05). However, in the control group, there was no significant difference in terms of mean pain intensity before and after the treatment across 3 days (p>0.05). No significant difference was observed between the mean anxiety of the 1st and 3rd days either (p>0.05).Conclusion: Considering the findings of this research, it can be concluded that reflexology has a positive effect on mitigating the intensity of pain and anxiety in metastatic cancer patients. Therefore, it is recommended that nurses employed in cancer centers benefit from the findings of this research to further help patients with cancer. It is also suggested that further research be conducted on the effect of reflexology on the pain and anxiety of other patients.

scholarly journals Features of immune status in patients with metastatic and glial brain tumors at the preparatory stage of radiotherapy

2020 ◽  
Vol 28 (4) ◽  
pp. 353-363
Author(s):  
A. A. Gryazov ◽  
M. I. Lisyany ◽  
A. B. Gryazov
Keyword(s):  
Innate Immunity ◽  
Radiation Therapy ◽  
Immune System ◽  
Brain Tumors ◽  
Cancer Patients ◽  
Immune Cells ◽  
Immune Status ◽  
Myeloperoxidase Activity ◽  
Metastatic Tumors ◽  
Significant Difference

Background. Studies carried out in recent decades have shown that immune cells are essential participants in the cancer process as well as cancerrelated inflammation. Focus has been increased on understanding the way how immune cells affect a tumor at different stages of the disease: early neoplastic transformation, clinically detected tumors, metastatic spread, and at surgery and radiotherapy stages. Purpose – assessing the status of the immune system in patients with brain tumors before radiation therapy and radiosurgery and comparing the features of immunity in metastatic and glial brain tumors. Materials and methods. The study presents the immunogram findings of 61 patients. Out of those: 18 patients with primary glial tumors and 23 patients with secondary metastatic tumors to the brain. The outcomes of 20 conditionally healthy non-cancer patients are presented as a control group. The age of patients is 24–75. All patients were histologically diagnosed with the tumor. Surgery was performed 1.0–3.0 years before the examination. Assessment of the immune system in patients with brain tumors was performed taking into account the cellular, humoral and phagocytic component of innate immunity. When assessing cellular immunity, the relative and absolute count of major lymphocyte subpopulations, such as CD3+ – general T-lymphocytes, CD4+ – T-lymphocytes-helpers, CD8+ – cytotoxic lymphocytes, CD16+ – natural killer lymphocytes, CD19+-B-lymphocytes, were calculated. Determining the humoral parameters included an assessment of quantitative values of IgG, IgM and IgA. Quantitative assessment of the phagocytic component of innate immunity included phagocytic activity of neutrophils (i. e. NBT test (Nitroblue Tetrazolium test), inducing (Zymosanum) and spontaneous neutrophil myeloperoxidase activity). Results. When comparing the immune parameters of the number of T- and B-subpopulations of lymphocytes in patients with primary malignant brain tumors and secondary metastatic tumors, no statistically significant difference has been detected between these params. Glioblastomas show higher levels of СD4+- and CD8+-lymphocytes in comparison with other tumour groups as well as higher levels of IgG and IgA than in other tumors, while IgM concentration is almost at the same level in three groups of patients. There is a tendency for reducing IgG and IgM level in the blood of patients with metastatic tumors. Both groups of cancer patients under study show inhibition of myeloperoxidase activity of neutrophils in the setting of maintaining the function of NBT cell activity. Conclusions. According to the findings obtained via studying immunological indicators of brain tumors, both metastatic and primary malignant glial ones, there are partial changes in various immune system components such as cellular, humoral and phagocytic activity. However, no statistically significant difference was detected between immune status indicators, that substantiates the need for further study of this issue. At the stage of preparation for radiation therapy, no significant changes in the immune system of the patients with brain tumors, that would make such treatment impossible and be consiered as one of contraindications, are observed.

scholarly journals Visualizing Frailty: Exploring Radiographical Measures of Frailty in Trauma Patients

2021 ◽  
Vol 11 (3) ◽  
pp. 121-128
Author(s):  
Omolola Fakunle ◽  
Meet Patel ◽  
Victoria G. Kravets ◽  
Adam Singer ◽  
Robert Hernandez-Irizarry ◽  
...  
Keyword(s):  
Frailty Index ◽  
Traumatic Injury ◽  
Ct Scans ◽  
Trauma Patients ◽  
Cross Sectional ◽  
Discharge Disposition ◽  
Psoas Muscles ◽  
Significant Difference ◽  
Modified Frailty Index ◽  
Relationship Of

Purpose: This study assessed the relationship of core muscle sarcopenia, myosteatosis, and L1 attenuation to the 5-factor modified frailty index (mFI-5), discharge disposition, and post-admission complications in orthopedic and general trauma patients. It was hypothesized that reduced sarcopenia, L1 attenuation, and increased myosteatosis is associated with higher mFI-5 scores (≥ 0.3), discharge into care, and increased post-admission complications.Methods: This prospective cohort study was performed at a Level 1 trauma center. Patients were surveyed and metrics of the mFI-5 were used. Frail was categorized as a mFI-5 score ≥ 0.3. Recent abdominal computed tomography (CT) scans were used to extract radiographical information of total psoas cross-sectional area, psoas myosteatosis, and L1 vertebrae attenuation.Results: There were 140 patients who consented to the study, of which 83 had available abdomen and pelvis CT scans. The mean age was 43.19 (± 17.36), and 65% were male (n = 52). When comparing the frail (16%, n = 13) and not frail (84%, n = 70) patients, there was a significant difference in mean psoas myosteatosis (p < 0.0001) and the attenuation of the L1 vertebrae (p < 0.001). On multivariate analysis when accounting for age, myosteatosis of the psoas muscles was predictive of an mFI-5 score ≥ 0.3.Conclusion: The findings suggest that myosteatosis and L1 attenuation are associated with frailty indices (mFI-5) after traumatic injury. Future studies are needed to prospectively assess the validity of both radiographical and index-based markers of frailty in predicting post-traumatic complications, mortality, and hospital utilization.

scholarly journals Comparison of sublingual buprenorphine and intravenous morphine in reducing bone metastases associated pain in cancer patients

2019 ◽  
Vol 29 (2) ◽  
Author(s):  
Seyed Mohammad Jamalian ◽  
Mohammad Sotodeh ◽  
Fathollah Mohaghegh
Keyword(s):  
Bone Metastases ◽  
Cancer Patients ◽  
Metastatic Cancer ◽  
Common Symptom ◽  
Duration Of Action ◽  
Sublingual Buprenorphine ◽  
Significant Difference ◽  
Intravenous Morphine ◽  
Group A ◽  
Group B

Bone metastases is one of the most common causes of pain in cancer patients and have a significant effect on their quality of life. The most common symptom of bone metastases is pain that gradually develops. Morphine is used to relieve pain in these patients, but poorly accepted due to its adverse events. Therefore, the current study was aimed to compare the effect of sublingual buprenorphine, with certainly lower complications with morphine. Fourth patients were divided into 2 groups. In group A, metastatic cancer patients received 2.5 mg of intravenous morphine. Furthermore, in group B, sublingual tablet of buprenorphine (one-fourth of a 500 μg tablet) was administered sublingually. Pain was measured 15, 30, and 45 minutes after the onset of pain using visual analog scale ruler. Based on the obtained data, two groups A and B were compared using SPSS 23 software. There was a significant difference between the patient's pain intensity after 15 and 30 minutes from the onset of pain in both groups. Due to the fact that the duration of the effect of morphine is 3-4 hours and the duration of the effect of sublingual buprenorphine is 6-8 hours, morphine showed fast acting forms of opioids (P= 0.001). The required dose level on the first day was similar in both groups and there was no statistically significant difference between the two groups. While on the second and third days, the median dose in group A (morphine) was greater than group B (buprenorphine), indicating prolonged duration of action for buprenorphine compared with morphine, thus requiring lower subsequent doses. The results of this study suggested that sublingual buprenorphine is a higher effective drug compared to intravenous morphine during and after operation. With regard to easy and painless administration, it seems that its use can be useful in controlling pain due to bone metastases in cancer patients.

Blood Concentrations of Interleukin-15 in Cancer Patients and Their Variations during Interleukin-2 Immunotherapy: Preliminary Considerations

1998 ◽  
Vol 13 (3) ◽  
pp. 169-171 ◽  
Author(s):  
P. Lissoni ◽  
F. Rovelli ◽  
M. Mandalà ◽  
S. Barni
Keyword(s):  
Cancer Immunotherapy ◽  
Cancer Patients ◽  
Metastatic Cancer ◽  
Cell Cancer ◽  
Interleukin 2 ◽  
Serum Levels ◽  
Control Group ◽  
Blood Concentrations ◽  
Significant Difference ◽  
Interleukin 15

In addition to the better known cytokines IL-2 and IL-12, IL-15, which is mainly produced by macrophages, is a new antitumor cytokine with a mechanism of action similar to that of IL-2. At present, however, there are no data about IL-15 secretion in cancer patients. This study was carried out to evaluate IL-15 blood concentrations in patients with early or advanced cancer and their possible variations in response to IL-2 cancer immunotherapy. The study included 40 patients with solid tumors, 24 of whom had metastatic disease. In addition, IL-15 secretion was evaluated during subcutaneous low-dose IL-2 therapy (6 million IU/day for 6 days/week for 4 weeks) in 14 metastatic renal cell cancer patients by collecting blood samples at weekly intervals. The control group consisted of 40 age-matched healthy subjects. Serum levels of IL-15 were measured by an enzyme immunoassay. No significant difference in mean serum levels of IL-15 was observed between cancer patients and controls. Moreover, the mean serum levels of IL-15 found in metastatic cancer patients were not significantly different from those found in patients with limited disease. Finally, no significant changes in mean levels of IL-15 occurred during IL-2 cancer immunotherapy. This preliminary study would suggest that IL-15 secretion is substantially within the normal range in cancer patients, both in early and advanced disease, and no variation seems to occur in response to IL-2 administration.

Anticoagulants for the treatment of venous thromboembolism in patients with cancer: An updated pairwise and network meta-analysis of randomized trials.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14692-e14692
Author(s):  
Shima Sidahmed ◽  
Ahmed Abdalla ◽  
Babikir Kheiri ◽  
Areeg Bala ◽  
Mohammed Salih ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Vitamin K ◽  
Major Bleeding ◽  
Metastatic Cancer ◽  
Meta Analysis ◽  
Number Needed To Treat ◽  
Cancer Type ◽  
Significant Difference ◽  
All Cause Mortality

e14692 Background: Cancer-associated venous thromboembolism (VTE) is common. Although low molecular weight heparin (LMWH) is the standard therapy in this setting, little is known with regard to non-vitamin K antagonist oral anticoagulants (NOACs). Therefore, we thought about evaluating the safety and efficacy of various anticoagulants in this vulnerable population. Methods: Electronic database search was conducted to identify randomized clinical trials (RCTs) that compared LMWH, NOACs, and/or vitamin-K-antagonists (VKA) in cancer patients. We performed frequentist direct and Bayesian network meta-analysis using random-effects model to calculate odds ratios (ORs), 95% confidence intervals (CIs), and 95% credible intervals (CrIs). The primary outcome was VTE (pulmonary embolism and deep-vein thrombosis) recurrence. Secondary outcomes were major bleeding and all-cause mortality. Results: We identified 13 RCTs with 6,595 total patients (mean age 62.4 ± 12.2; 50.4% female; 17.7% hematological malignancies; and 6 months median follow-up). The most common cancer type was colorectal and 48% of the population had metastatic cancer at baseline. NOACs were associated with significantly reduced VTE recurrence compared with VKA (OR = 0.58; 95% CI = 0.40-0.83; P < 0.01; number needed to treat [NNT] = 40) and LMWH (OR = 0.46; 95% CI = 0.25-0.85; P = 0.01; NNT = 20). LMHW was associated with significantly reduced VTE recurrence compared with VKA (OR = 0.52; 95% CI = 0.39-0.71; P < 0.01; NNT = 18). NOACs were associated with significantly reduced major bleeding compared with VKA (OR = 0.56; 95% CI = 0.35-0.91; P = 0.02; NNT = 64). There was no significant difference identified between the anticoagulant groups in regard to all-cause mortality. Conclusions: Among cancer patients with VTE, NOACs were associated with significantly reduced VTE recurrence compared to LMWH and VKA, and significantly reduced major bleeding compared with VKA. LMWH was associated with significantly reduced VTE recurrence compared with VKA.

scholarly journals Gunshot wounds to the head: racial disparities in inpatient management and outcomes

2019 ◽  
Vol 47 (5) ◽  
pp. E11 ◽  
Author(s):  
Ryan G. Chiu ◽  
Angelica M. Fuentes ◽  
Ankit I. Mehta
Keyword(s):  
African American ◽  
Racial Disparities ◽  
Trauma Care ◽  
Length Of Hospital Stay ◽  
Gunshot Wounds ◽  
Hospital Charges ◽  
Total Hospital ◽  
Discharge Disposition ◽  
Cranial Trauma ◽  
Inpatient Management

OBJECTIVESeveral studies have indicated that racial disparities may exist in the management and outcomes of acute trauma care. One segment of trauma care that has not been as extensively investigated, however, is that of cranial trauma care. The goal of this study was to determine whether significant differences exist among racial and ethnic groups in various measures of inpatient management and outcomes after gunshot wounds to the head (GWH).METHODSIn this study, the authors used the Nationwide (National) Inpatient Sample (NIS) to investigate all-cause mortality, receipt of surgery, days from admission to initial intervention, discharge disposition, length of hospital stay, and total hospital charges of those with GWH from 2012 to 2016. A 1:1 propensity score–matched analysis was conducted to evaluate the effect of race on these endpoints, while controlling for baseline demographics and comorbidities.RESULTSA total of 333 patients met the inclusion and exclusion criteria: 148 (44.44%) white/Caucasian, 123 (36.94%) black/African American, 54 (16.22%) Hispanic/Latinx, and 8 (2.40%) Asian. African American patients were sent to immediate care and rehabilitation significantly less often than Caucasian patients (RR 0.17 [95% CI 0.04–0.71]). There were no significant differences in mortality, length of stay, rates of surgical intervention, or total hospital charges among any of the racial groups.CONCLUSIONSThe authors’ findings suggest that racial disparities in inpatient cranial trauma care and outcomes may not be as prevalent as previously thought. In fact, the disparities seen were only in disposition. More research is needed to further elucidate and address disparities within this population, particularly those that may exist prior to, and after, hospitalization.

Thirty-day readmissions in metastatic cancer patients: Room for improvement?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6541-6541 ◽  
Author(s):  
Rachel Solomon ◽  
Natalia Egorova ◽  
Rebeca Franco ◽  
Nina A. Bickell
Keyword(s):  
Cancer Patients ◽  
Metastatic Cancer ◽  
Private Insurance ◽  
New York State ◽  
Primary Diagnosis ◽  
Public Hospitals ◽  
Hospital Type ◽  
Readmission Rates ◽  
Discharge Disposition ◽  
Increased Risk

6541 Background: To date, cancer has been excused from most readmission reduction efforts. Yet reported readmission rates for cancer patients discharged from medical services are as high as 27%. Some readmissions for patients with metastatic disease may be avoidable. We assessed the prevalence of potentially preventable readmissions and associated factors in adult patients with metastatic cancer. Methods: We measured 30 day readmissions for dehydration, cancer-related pain, and failure to thrive in patients with primary diagnosis metastatic cancer on index admission to a New York State hospital between December 1, 2012 and December 31, 2014. We used competing risk models to assess the effects of demographics, comorbidities, hospital type, payor, and discharge disposition. Results: During the study period, 11,275 patients had 19,307 index hospitalizations with primary diagnosis, metastatic cancer. The 30 day readmission rate was 24.5% of which 8.9% (424) were potentially preventable. Black (HR 1.26, 1.17-1.35) and Hispanic patients (HR 1.19, 1.09-1.31) had higher rates of readmission than whites. Being older (HR per 10 years of age 0.94, 0.90-0.97), female (HR 0.95, 0.91-0.99), having private insurance (HR 0.87, 0.87-0.81) and discharge to hospice (HR 0.62, 0.42-0.91) decreased risk of readmission. Discharge home with services (HR 1.21, 1.14-1.27) or to a skilled nursing facility (SNF) (HR 1.11, 1.01-1.23) conferred higher risk than going home unaided. Index hospitalization at public hospitals increased risk (HR 1.1, 1.02-1.18); teaching hospitals were protective (HR 0.84, 0.774-0.92). Patients with potentially preventable readmissions were younger (HR per 10 years of age 0.85, 0.78-0.93). Compared to those who went home unaided, patients discharged with services were more likely (HR 1.31, 1.05-1.64) and those discharged to SNF were less likely to have avoidable returns (HR 0.55, 0.37-0.81). Payor, gender, race, comorbidities, and index hospital type did not contribute. Conclusions: While the overall rate of potentially preventable admissions among metastatic cancer patients is low, higher readmission rates among those discharged home with help suggests that services supplied are not sufficient to address their health needs.

Sign in / Sign up

Export Citation Format

Share Document