Thromboembolic events in hospitalized cancer patients: Impact on stay duration and cost for four major cancer localizations.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 186-186
Author(s):  
Florian Scotte ◽  
Alexandre Vainchtock ◽  
Nicolas Martelli ◽  
Isabelle Borget
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Thromboembolic Events ◽  
Cancer Management ◽  
Venous Thromboembolic Events ◽  
The Impact

186 Background: Cancer patients represent an at-risk population for Venous Thromboembolic Events (VTE). Our study aimed to evaluate the impact of VTE on the length and cost of hospital stay in French patients hospitalized for breast cancer (BC), colon cancer (CC), lung cancer (LC) or prostate cancer (PC). Methods: The French national hospital database (PMSI) and the disease-specific ICD-10 codes were used to identify BC, CC, LC or PC patients diagnosed in 2010 who were hospitalized with a VTE during the following two years. We selected stays during which a VTE occurred but was not the main reason of hospitalization (cancer was classified as primary/related diagnosis and VTE as significant associated diagnosis). Those stays were matched and compared to similar stays (same cancer and same reason for hospitalization) without VTE. Costs were calculated using the French official tariffs, from the perspective of the third-party payer. Results: We identified 214 stays for breast cancer during which a VTE occurred and was classified as significant associated diagnosis, 843 stays for colon cancer, 1301 for lung cancer, and 126 for prostate cancer. The comparison between those stays and similar stays without VTE showed significant increase of hospital stay duration in patients experiencing VTE. Median duration rose from 4 to 7 days in BC patients, from 8 to 16 days in CC, from 2 to 9 days in LC and from 6 to 10 days in PC. Consequently, the median expenditure per stay increased by 37% in BC patients with VTE (up to € 5,518), by 61% in CC (up to € 9,878), by 202% in LC (up to € 7,308) and by 22% in PC (up to € 6,200). Conclusions: When occurring during hospitalization, VTE made cancer management much heavier: patients faced prolonged hospital stays whereas healthcare system faced significant additional cost. Better prevention and follow-up measures could reduce this burden, and benefit both patients and hospitals. [Table: see text]

scholarly journals Thrombosis in Cancer Patients during Hospitalization: Impact on Stays and Costs

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4487-4487
Author(s):  
Isabelle Borget ◽  
Florian Scotte ◽  
Nicolas Martelli ◽  
Alexandre Vainchtock ◽  
Ismail Elalamy
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Lung Cancer ◽  
Colon Cancer ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Public Hospitals ◽  
Recurrent Event ◽  
Additional Costs

Abstract Background: Cancer patients represent an at-risk population for Venous Thromboembolic Events (VTE). Following a previous study on two localizations, we intended to determine the incidence and recurrence rate of VTE in breast cancer (BC), colon cancer (CC), lung cancer (LC) and prostate cancer (PC), four of the most frequent cancers in France. We evaluate their impact on the number and the duration of hospitalizations and calculate the additional costs for hospitals compared to cancer patients without VTE. Methods: The French national hospital database (PMSI) was used to identify BC, CC, LC and PC patients diagnosed in 2010 who were hospitalized for a VTE during the following two years. The number of stays induced by a VTE, the number of patients hospitalized or re-hospitalized and the time before recurrent event were determined using the disease-specific ICD-10 codes, among all VTEs classified as primary or related diagnosis (PD / RD) and significant associated diagnosis (SAD). Subsequently, we evaluated the extra cost and extra duration of stay when a VTE is managed during a hospitalization. Therefore, we selected stays during witch a VTE is managed but was not the main reason of hospitalization (cancer was classified as primary/related diagnosis and VTE as significant associated diagnosis). Those stays were matched and compared to similar stays without VTE. Costs were estimated from the healthcare system perspective, using the French official tariffs. Results: Among 194,964 patients newly diagnosed in 2010 with BC, CC, LC and PC in 2010, 1,271 (2.0%) BC patients, 2,866 (6.0%) CC patients, 3,775 (9,6%) LC patients and 997 (2.2%) PC patients, were hospitalized for a VTE or experienced a VTE during a hospital stay, over two years. In total, 12,880 stays related to VTE were identified. We found that 2.053 cancer patients (23.0% of all VTE patients) were re-hospitalized at least once with a recurrent VTE, representing 3,969 admissions (30.8% of total admissions). In those patients with VTE recurrence, median time between first and recurrent event was 23 days in BC patients, 22 days in CC patients, 19 days in LC patients 25 days in PC patients. In the second part of our study, the comparison between stays for cancer during which a VTE occurred and stays for cancer without VTE showed that the duration of hospital stay was longer in patients with VTE: in public hospitals, median stay duration raised from 4 to 7 days for BC, from 8 to 16 days in CC, from 2 to 9 days in LC and from 6 to 10 days in PC. VTE consequently induced a significant extra cost related to hospitalizations over the two years of follow-up: in public hospitals, the median expenditure per stay increased by 37% in BC, (up to Û 5,518), by 61% in CC (up to Û9,878), by 202% in LC (up to Û7,308) and by 22% in PC (up to Û6,200). Conclusion: VTE appeared to make cancer management much heavier as patients faced increased hospital stays duration whereas healthcare system faced important additional costs. Better prevention and follow-up guidelines could reduce this burden, and benefit both patients and hospitals. Table. Median hospital stay duration and cost in cancer patients with and without VTE as SAD Breast cancer Colon cancer Lung cancer Prostate cancer Duration (days) Cost Duration (days) Cost Duration (days) Cost Duration (days) Cost With VTE 7 Û 5,518 16 Û9,878 9 Û7,308 10 Û 6,200 Without VTE 4 Û 4,018 8 Û6,171 2 Û2,422 6 Û 5,094 Disclosures No relevant conflicts of interest to declare.

The Impacts of Thromboembolic Events in Breast and Prostate Cancer Patients: Incidence, Hospitalization Duration and Costs

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 4828-4828
Author(s):  
Isabelle Borget ◽  
Guy Meyer ◽  
Alexandre Vainchtock ◽  
Nicolas Martelli ◽  
Florian Scotté ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Hospital Stay ◽  
Cancer Patients ◽  
Research Funding ◽  
Public Hospitals ◽  
Extra Cost ◽  
Recurrent Event ◽  
Thromboembolic Events

Abstract Background: Cancer patients represent an at-risk population for Venous Thromboembolic Events (VTE). We intended to determine the incidence and recurrence rate of VTE in breast cancer (BC) and prostate cancer (PC) French patients, to evaluate their impacts on the number and the duration of hospitalizations and to calculate their additional cost for hospitals. Methods: The French national hospital database (PMSI) was used to identify BC and PC patients diagnosed in 2010 who were hospitalized for a VTE during the following two years. The number of stays induced by a VTE, the number of patients hospitalized or re-hospitalized and the time before recurrent event were determined using the disease-specific ICD-10 codes, among all VTEs classified as primary or related diagnosis (PD / RD) and significant associated diagnosis (SAD). Subsequently, we evaluated the extra cost and extra length of stay when a VTE ocurred during a hospitalization: respectively 275 stays for breast cancer and 292 stays for prostate cancer during which a VTE occurred and prolonged the stay (cancer was classified as PD/PR and the VTE as SAD) were matched and compared to similar stays without VTE. We calculated the hospital costs using the French official tariffs, from the perspective of the third-party payer. Results: We identified 62,365 new patients with BC and 45,551 new patients with PC. During the two-year follow-up period, 1,271 with BC (2.0%) and 997 with PC (2.2%) were hospitalized for a VTE or experienced a VTE during a hospital stay. In total, 1,604 and 1,210 stays related to first VTE or recurrent VTE were analyzed for BC patients and PC patients, respectively. We found that 202 BC patients and 144 PC patients were re-hospitalized at least once for a recurrent VTE, representing 546 admissions (19.4% of total admissions). In those patients with VTE recurrence, median time before recurrent event was 23 days in BC patients and 25 days in PC patients. The comparison between stays during which a VTE occurred and stays without VTE showed that the duration of hospital stay was longer in patients with VTE: in public hospitals, median stay duration for BC patients with VTE raised by 133% to 7 days (vs. 3 days for BC patients without VTE), and by 67% to 10 days for PC patients (vs. 6 days for patients without VTE). VTE consequently induced a significant extra cost related to hospitalizations over the two years of follow-up: the median expenditure per stay showed an increase of 37.3% in BC, up to 5,518 Euros (vs. 4,018 Euros per stay without VTE) and of 21.7% in PC up to 6,200 Euros (vs. 5,094 Euros per stay without VTE). Conclusion: VTE appeared to make cancer management much heavier as patients faced increased hospital stays number and duration whereas healthcare system faced important additional costs. This burden may be reduced by decreasing the occurrence of thromboembolic complications and their recurrence in cancer patients, with better prevention and follow-up measures. Table. Hospital stay duration in patients with breast or prostate cancer as PD / RD and VTE as significant associated diagnosis compared to patients without VTE (in public hospitals) Median stay duration (days) Mean stay duration (days) Breast cancer Patients with VTE 7 11.32 Patients without VTE 3 4.56 Prostate cancer Patients with VTE 10 13.52 Patients without VTE 6 6.98 Disclosures Borget: LEO Pharma: Honoraria. Meyer:LEO Pharma: Research Funding. Vainchtock:HEVA: Research Funding. Martelli:LEO Pharma: Honoraria. Scotté:LEO Pharma: Honoraria.

scholarly journals Cognitive impairment after cytotoxic chemotherapy

2019 ◽  
Vol 7 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Petra Huehnchen ◽  
Antonia van Kampen ◽  
Wolfgang Boehmerle ◽  
Matthias Endres
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Cognitive Impairment ◽  
Cancer Patients ◽  
Cytotoxic Chemotherapy ◽  
Cytotoxic Drugs ◽  
Cytotoxic Agents ◽  
Cancer Type ◽  
Breast Cancer Patients ◽  
The Impact

Abstract Background Neurotoxicity is a frequent side effect of cytotoxic chemotherapy and affects a large number of patients. Despite the high medical need, few research efforts have addressed the impact of cytotoxic agents on cognition (ie, postchemotherapy cognitive impairment; PCCI). One unsolved question is whether individual cytotoxic drugs have differential effects on cognition. We thus examine the current state of research regarding PCCI. Neurological symptoms after targeted therapies and immunotherapies are not part of this review. Methods A literature search was conducted in the PubMed database, and 1215 articles were reviewed for predefined inclusion and exclusion criteria. Thirty articles were included in the systematic review. Results Twenty-five of the included studies report significant cognitive impairment. Of these, 21 studies investigated patients with breast cancer. Patients mainly received combinations of 5-fluorouracil, epirubicin, cyclophosphamide, doxorubicin, and taxanes (FEC/FEC-T). Five studies found no significant cognitive impairment in chemotherapy patients. Of these, 2 studies investigated patients with colon cancer receiving 5-fluorouracil and oxaliplatin (FOLFOX). Independent risk factors for PCCI were patient age, mood alterations, cognitive reserve, and the presence of apolipoprotein E e4 alleles. Conclusions There is evidence that certain chemotherapy regimens cause PCCI more frequently than others as evidenced by 21 out of 23 studies in breast cancer patients (mainly FEC-T), whereas 2 out of 3 studies with colon cancer patients (FOLFOX) did not observe significant changes. Further studies are needed defining patient cohorts by treatment protocol in addition to cancer type to elucidate the effects of individual cytotoxic drugs on cognitive functions.

Statins, aspirin and risk of venous thromboembolic events in breast cancer patients

2013 ◽  
Vol 38 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Ayelet Shai ◽  
Hedy S. Rennert ◽  
Ofer Lavie ◽  
Muona Ballan-Haj ◽  
Arie Bitterman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Thromboembolic Events ◽  
Breast Cancer Patients ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

The action of Erythropoietin on venous thromboembolic events in lung cancer patients

2018 ◽  
Vol 164 ◽  
pp. S242
Author(s):  
E. Dimakakos ◽  
A. Kakavetsi ◽  
I. Gkiozos ◽  
A. Charpidou ◽  
I. Kotteas ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Thromboembolic Events ◽  
Lung Cancer Patients ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic

scholarly journals Gender-specific aspects of epidemiology, molecular genetics and outcome: lung cancer

ESMO Open ◽  
2020 ◽  
Vol 5 (Suppl 4) ◽  
pp. e000796
Author(s):  
Nuria Mederos ◽  
Alex Friedlaender ◽  
Solange Peters ◽  
Alfredo Addeo
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Lung Cancer ◽  
Gender Differences ◽  
Sex And Gender ◽  
Never Smokers ◽  
And Gender ◽  
The Impact ◽  
Gender Specific ◽  
Sex And Gender Differences

Lung cancer remains the leading cause of cancer-related deaths worldwide in women and men. In incidence, lung cancer ranks second, surpassed by breast cancer in women and prostate cancer in men. However, the historical differences in mortality and incidence rate between both sexes have changed in the last years. In the last decades, we have also witnessed an increased number of lung cancer in female never-smokers. These disparities have grown our interest in studying the impact of the gender and sex in the presentation of lung cancer. The aetiology is yet to be fully elucidated, but the data are clear so far: there is a growing divide between lung cancer presentation in women and men that will change our management and study of lung cancer. This article aims to review the sex and gender differences in lung cancer.

Changes in stage at diagnosis of screenable cancers after the Affordable Care Act.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6521-6521 ◽  
Author(s):  
Xuesong Han ◽  
Chun Chieh Lin ◽  
Ahmedin Jemal
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Colorectal Cancer ◽  
Lung Cancer ◽  
Cervical Cancer ◽  
Cancer Patients ◽  
Female Breast Cancer ◽  
Stage I ◽  
Stage At Diagnosis ◽  
Female Breast

6521 Background: Extensive evidence links inadequate insurance with later stage at cancer diagnosis, particularly for cancers that can be detected by screening. The Affordable Care Act (ACA) implemented in 2014 has substantially increased insurance coverage for Americans 18-64 years old. This study aims to examine any changes in stage at diagnosis after the ACA for the following cancers for which screening is recommended for individuals at risk: female breast cancer, colorectal cancer, cervical cancer, prostate cancer, and lung cancer. Methods: We used National Cancer Data Base, a nationally hospital-based cancer registry capturing 70% new cancer cases in the US each year, to identify nonelderly cancer patients with screening-appropriate age who were diagnosed during 2013-2014. The percentage of stage I disease was calculated for each cancer type before (2013 Q1-Q3) and after (2014 Q2-Q4) the ACA. 2013 Q4-2014 Q1 was excluded as a washout/phase-in period. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated using log-binomial models controlling for age, race/ethnicity and sex if applicable. Results: 121,855 female breast cancer patients aged 40-64 years, 39,568 colorectal cancer patients aged 50-64 years, 11,265 cervical cancer patients aged 21-64 years, 59,626 prostate cancer patients aged 50-64 years, and 41,504 lung cancer patients aged 55-64 years were identified. After the implementation of the ACA, the percentage of stage I disease increased statistically significantly for female breast cancer (47.8% vs. 48.9%; PR = 1.02 [95%CI 1.01-1.03]), colorectal cancer (22.8% vs. 23.7%; PR = 1.04 [95%CI 1-1.08]), and lung cancer (16.6% vs. 17.7%; PR = 1.06 [95% CI 1.02-1.11]). A shift to stage I disease was also observed for cervical cancer (47.2% vs. 48.7%; PR = 1.02 [95% CI 0.98-1.06]) although not statistically significant. In contrast, the percentage of stage I decreased for prostate cancer (18.5% vs. 17.2%; PR = 0.93 [95%CI 0.9-0.96]) in 2014. Conclusions: The implementation of the ACA is associated with a shift to early stage at diagnosis for all screenable cancers except prostate cancer, which may reflect the recent US Preventive Services Task Force recommendations against routine prostate cancer screening.

Persistence of Medical Change at Implementation of Clinical Guidelines on Medical Practice: A Controlled Study in a Cancer Network

2005 ◽  
Vol 23 (19) ◽  
pp. 4414-4423 ◽  
Author(s):  
Isabelle Ray-Coquard ◽  
Thierry Philip ◽  
Guy de Laroche ◽  
Xavier Froger ◽  
Jean-Philippe Suchaud ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colon Cancer ◽  
Medical Practice ◽  
Controlled Study ◽  
Control Group ◽  
Cancer Management ◽  
Cancer Network ◽  
And Control ◽  
The Impact ◽  
Experimental Group

Purpose A cancer network of general or private hospitals of a French region was started in 1995 for improving quality of care and rationalizing medical prescriptions. The impact of implementing a clinical practice guidelines (CPG) project assessed conformity with guidelines in medical practice; significant changes were observed within the network, whereas no changes were observed in a control region without cancer network. In the present study, we evaluated the persistence of conformity to guidelines through a new medical audit. Patients and Methods In 1999, the hospitals of the previously compared experimental and control groups accepted to reassess the impact of CPG. A controlled transversal study was performed in the experimental group (cancer network) and in the control group (no regional cancer network). In 1996 (first audit) and in 1999 (present audit), all new patients with colon cancer (177 and 200 in experimental group and 118 and 100 in control group, respectively) and early breast cancer (444 and 381 in experimental group and 172 and 204 in control group, respectively) were selected. Results In the experimental group, the compliance of medical decisions with CPG was significantly higher in 1999 than in 1996 for colon cancer (73%; 95% CI, 67% to 79% v 56%; 95% CI, 49% to 63%, respectively; P = .003) and similar for the two periods for breast cancer (36%; 95% CI, 31% to 41% v 40%; 95% CI, 35% to 44%, respectively; P = .24). In the control group, compliance was significantly higher in 1999 than in 1996 for colon cancer (67%; 95% CI, 58% to 76% v 38%; 95% CI, 29% to 47%, respectively; P < .001) and identical for the two periods for breast cancer (4%; 95% CI, 1% to 7% v 7%; 95% CI, 3% to 11%, respectively; P = .19). Conclusion The CPG program for cancer management produced persistent changes in medical practice in our cancer network in terms of conformity with CPG.

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