scholarly journals Influenza in hospitalised patients with malignancy: a propensity score matching analysis

ESMO Open ◽  
2020 ◽  
Vol 5 (5) ◽  
pp. e000968
Author(s):  
Jiarui Li ◽  
Dingding Zhang ◽  
Zhao Sun ◽  
Chunmei Bai ◽  
Lin Zhao
Keyword(s):  
High Risk ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Influenza Infection ◽  
Influenza Viruses ◽  
High Risk Population ◽  
Propensity Score Matching Analysis ◽  
Hospitalised Patients ◽  
The Impact

BackgroundPatients with malignancy are vulnerable to influenza viruses and are at high risk of developing serious complications. However, few studies have investigated the impact of influenza infection among hospitalised patients with malignancy.MethodsCancer-related hospitalisations were identified by using data from National Inpatient Sample in the USA between 2012 and 2014. We conducted a 1:1 propensity score matching analysis to compare the in-hospital outcomes between cancer patients with and without influenza. Multivariate logistic regression analyses were also performed to identify independent prognosis predictors of mortality.ResultsWe identified 13 186 849 weighted cancer-related hospitalisations during the study period, and 47 850 of them (0.36%) had a concomitant diagnosis of influenza. After propensity score matching, cancer patients with concomitant influenza had a higher mortality (5.4% vs 4.2%; OR, 1.30; 95% CI, 1.13 to 1.49; p<0.001), longer length of stay (6.3 days vs 5.6 days; p<0.001) but lower costs (US$14 605.9 vs US$14 625.5; p<0.001) in hospital than those without influenza. In addition, cancer patients with influenza had a higher incidence of complications, including pneumonia (18.4% vs 13.2%; OR, 1.49; 95% CI, 1.37 to 1.62; p<0.001), neutropenia (7.1% vs 3.4%; OR, 2.18; 95% CI, 1.91 to 2.50; p<0.001), sepsis (19.5% vs 9.3%; OR, 2.36; 95% CI, 2.16 to 2.58; p<0.001), dehydration (14.8% vs 8.8%; OR, 1.80; 95% CI, 1.65 to 1.97; p<0.001) and acute kidney injury (19.9% vs 17.6%; OR, 1.16; 95% CI, 1.08 to 1.25; p<0.001) than those without influenza. Older age, no insurance, more comorbidities, lung cancer and haematological malignancy were independently associated with higher mortality.ConclusionInfluenza is associated with worse in-hospital clinical outcomes among hospitalised patients with malignancy. Annual influenza vaccination and early initiation of antiviral therapy are recommended in this high-risk population.

Influenza in hospitalized cancer patients: A propensity score matching analysis.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 170-170
Author(s):  
Jiarui Li ◽  
Dingding Zhang ◽  
Lin Zhao ◽  
Zhao Sun ◽  
Chunmei Bai
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Clinical Outcomes ◽  
Influenza Infection ◽  
Kidney Injury ◽  
The United States ◽  
Influenza Viruses ◽  
Propensity Score Matching Analysis ◽  
The Impact

170 Background: Cancer patients are vulnerable to influenza viruses and are at great risk of developing related complications. However, few studies have assessed the impact of influenza infection among hospitalized cancer patients in the United States. Methods: We identified cancer-related hospitalizations from National Inpatient Sample between 2012 and 2014. A 1:1 propensity score matching analysis was conducted to compare the clinical outcomes between hospitalized cancer patients with and without influenza. Results: We identified 13,186,849 cancer-related hospitalizations, and 47,850 of them (0.36%) had a concomitant diagnosis of influenza. After propensity score matching, cancer patients with influenza had a higher mortality (5.4% vs. 4.2%; odds ratio [OR]: 1.3; 95% confidence interval [CI], 1.13 to 1.49; P < 0.001), longer length of stay (6.3 vs. 5.6 days; P < 0.001) but lower costs (14605.9 vs. 14625.5 dollars; P < 0.001) in hospital than those without influenza. In addition, patients with influenza had a higher incidence of pneumonia (18.4% vs. 13.2%; OR, 1.49; 95% CI, 1.37 to 1.62; P < 0.001), neutropenia (7.1% vs. 3.4%; OR, 2.18; 95% CI, 1.91 to 2.50; P < 0.001), sepsis (19.5% vs. 9.3%; OR, 2.36; 95% CI, 2.16 to 2.58; P < 0.001), dehydration (14.8% vs. 8.8%; OR, 1.80; 95% CI, 1.65 to 1.97; P < 0.001), and acute kidney injury (19.9% vs. 17.6%; OR, 1.16; 95% CI, 1.08 to 1.25; P < 0.001) than those without influenza. Conclusions: Influenza is associated with worse clinical outcomes among hospitalized cancer patients. Influenza vaccination is recommended in this population.

Impact of chemotherapy on prognosis of resectable pathological T3N0M0 esophageal cancer patients: a population-based study

2021 ◽  
Author(s):  
Xiang Gu ◽  
Yizhi Ge ◽  
Jia Liu ◽  
Qian Ding ◽  
Junfeng Chu ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Cancer ◽  
Propensity Score ◽  
Cell Carcinoma ◽  
Propensity Score Matching ◽  
Squamous Cell ◽  
Protective Factor ◽  
Histological Type ◽  
Propensity Score Matching Analysis ◽  
The Impact

Aims: This study aimed to retrospectively determine the influence factors and survival effects of chemotherapy in pathological T3N0M0 esophageal cancer (EC) patients based on histological type. Methods: A total of 1136 pathological T3N0M0 EC patients who had surgery were chosen from the Surveillance, Epidemiology and End Results database. The patients were divided into subgroups based on histological type and chemotherapy status. Multivariate logistic regression, log-rank test and Cox regression were used to identify prognostic risk factors and survival differences. A propensity score matching analysis was applied to adjust the covariates. The impact of additional chemotherapy was also assessed in patients who had postoperative radiotherapy. Results: The 5-year overall survival was 36.4% for all patients. Chemotherapy was an independent protective factor of survival in both adenocarcinoma and squamous cell carcinoma patients. In the survival analysis, chemotherapy significantly improved the prognosis of EC patients, both for adenocarcinoma and squamous cell carcinoma. Propensity score matching analysis validated these results. Conclusion: Chemotherapy is recommended for pathological T3N0M0 EC patients regardless of histological type.

Impact of adjuvant chemotherapy with S-1 on survival in patients with type 4 and large type 3 gastric cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 98-98
Author(s):  
Hayato Omori ◽  
Sanae Kaji ◽  
Rie Makuuchi ◽  
Tomoyuki Irino ◽  
Yutaka Tanizawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Adjuvant Chemotherapy ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Cancer Patients ◽  
Strong Impact ◽  
Large Type ◽  
Gastric Cancer Patients ◽  
Type 3 ◽  
The Impact

98 Background: The prognosis of patients with linitis plastica (type 4) and large ulcero-invasive-type (type 3) gastric cancer is reported to be extremely poor. In stage II/III gastric cancer, adjuvant chemotherapy with S-1 is a standard treatment in Japan. However, the efficacy of postoperative chemotherapy with S-1 in these types of patients with dismal prognosis is unknown. The aim of this study is to evaluate the impact of adjuvant chemotherapy with S-1 on survival in type 4 and large type 3 gastric cancer patients. Methods: A total of 152 patients with clinically resectable type 4 and large type 3 gastric cancer who underwent R0 or R1 surgery from 2002 to 2014 were included. The survival outcome between patents with surgery alone and patients who received adjuvant S-1 was compared using a 1:1 propensity score matching method. Results: Patients with adjuvant S-1 were significantly younger (67 vs 74 y, p = 0.009), had higher incidence of T4 (90 vs 62%, p < 0.001), N2-3 (84 vs 63%, p = 0.008), and cytology positive (52 vs 29%, p = 0.006) than in surgery alone patients. Before matching, median survival time (MST) was not different in surgery alone (n = 52) and adjuvant S-1 (n = 100) (31.3 vs 35.8 months, p = 0.41). Propensity score matching yielded 48 patients (24 patients in each group). After matching, baseline characteristics were well balanced between the two groups. Survival in patients with adjuvant S-1 was significantly better than in surgery alone patients (MST: 50.3 vs 15.4 months, p = 0.002). Cox proportional hazard analysis revealed adjuvant S-1 treatment was selected as independent prognostic factor (HR: 0.38, 95%CI: 0.18-0.76, p = 0.006), as well as lavage cytology (HR: 3.9, 95%CI: 1.8-8.9, p < 0.001). Conclusions: Adjuvant chemotherapy with S-1 may have a strong impact on survival in type 4 and large type 3 gastric cancer patients. The efficacy of this treatment will be further demonstrated in the future clinical trials.

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