scholarly journals S319 Are We Screening for Colorectal Cancer During Inpatient Hospital Admissions? 15-year Trends of Inpatient Screening Colonoscopies

2021 ◽  
Vol 116 (1) ◽  
pp. S138-S138
Author(s):  
Tamta Chkhikvadze ◽  
Ese Uwagbale ◽  
Elmarie Alexander ◽  
Junxin Shi
Keyword(s):  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Inpatient Hospital

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

Cancers ◽  
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.

Risk-adjustment models for breast, lung, and colorectal cancer cost, utilization, and outcomes in a commercially insured population.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18340-e18340
Author(s):  
Bhuvana Sagar ◽  
Yu Shen Lin ◽  
Liana Desharnais Castel
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Her2 Positive ◽  
Cost Drivers ◽  
Cancer Breast ◽  
Clinical Biomarkers ◽  
Cost Utilization

e18340 Background: Advances in oncology have led to rising costs which are unsustainable, necessitating value-based arrangements that maximize quality and overall outcomes. Our objective was to identify clinical and patient factors that predict higher costs and utilization among breast, lung, and colorectal cancer in a commercial population. Methods: We conducted a longitudinal analysis of claims in a sample of 9,748 commercially insured patients with breast, lung, and colorectal cancer, to measure costs and utilization based on presence of metastases, proxies for clinical biomarkers, patient demographics, and treatments. Results: Episode Risk Group (ERG) risk score, metastasis, and facility provider affiliation were cost drivers for all three types of cancer (breast, lung, and colorectal). Hypertension and younger age were cost drivers for breast cancer. In addition, HER2 positive status (β = 68,946, SE = 2,104, p < .0001) was significant in breast cancer, and VEGF in both lung (β = 56,975, SE = 10,138, p < .0001) and colorectal (β = 24,400, SE = 5,671, p < .0001) cancers. Metastasis also was associated with greater hospital admissions and hospital length of stay in all three cancers. Chemotherapy and supportive drug therapies accounted for the highest proportions of total medical costs among beneficiaries observed. Conclusions: Value-based reimbursement models in oncology should appropriately risk adjust by accounting for key cost drivers. Although claims-based methodologies may be further augmented with clinical data, we recommend adjusting for the factors we identified in models to predict costs and outcomes in breast, lung, and colorectal cancers.

scholarly journals Colonic Stents for Colorectal Cancer Are Seldom Used and Mainly for Palliation of Obstruction: A Population-Based Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Anna M. Borowiec ◽  
Charlie S. K. Wang ◽  
Elaine Yong ◽  
Calvin Law ◽  
Natalie Coburn ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Metastatic Disease ◽  
Hospital Admissions ◽  
Operative Management ◽  
Population Based ◽  
Emergency Department Visits ◽  
Stent Insertion ◽  
Colonic Stents ◽  
Health Care Encounters

Self-expandable stents for obstructing colorectal cancer (CRC) offer an alternative to operative management. The objective of the study was to determine stent utilization for CRC obstruction in the province of Ontario between April 1, 2000, and March 30, 2009. Colonic stent utilization characteristics, poststent insertion health outcomes, and health care encounters were recorded. 225 patients were identified over the study period. Median age was 69 years, 2/3 were male, and 2/3 had metastatic disease. Stent use for CRC increased over the study period and gastroenterologists inserted most stents. The median survival after stent insertion was 199 (IQR, 69–834) days. 37% of patients required an additional procedure. Patients with metastatic disease were less likely to go on to surgery (HR 0.14, 95% CI 0.06–0.32,p<0.0001). There were 2.4/person-year emergency department visits (95% CI 2.2–2.7) and 2.3 hospital admissions/person-year (95% CI 2.1–2.5) following stent insertion. Most admissions were cancer or procedure related or for palliation. Factors associated with hospital admissions were presence of metastatic disease, lack of chemotherapy treatment, and stoma surgery. Overall the use of stents for CRC obstruction remains low. Stents are predominantly used for palliation with low rates of postinsertion health care encounters.

Fall-related sub-acute and non-acute care and hospitalised rehabilitation episodes of care: what is the injury burden?

2013 ◽  
Vol 37 (3) ◽  
pp. 348 ◽  
Author(s):  
Rebecca J. Mitchell ◽  
Jacqui Close ◽  
Ian D. Cameron ◽  
Stephen Lord
Keyword(s):  
Data Quality ◽  
Acute Care ◽  
Resource Use ◽  
Linked Data ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
Inpatient Rehabilitation ◽  
Rehabilitation Services ◽  
Inpatient Hospital ◽  
Epidemiological Profile

Background Falls are the leading cause of injury in older people. Rehabilitation services can assist individuals to improve mobility and function after sustaining a fall-related injury. However, the true effect of fall-related injury resulting in hospitalisation is often underestimated because of failure to consider sub-acute and non-acute care provided following the acute hospitalisation episode. Aim This study aims to describe the sub-acute and non-acute health service use of individuals hospitalised in New South Wales (NSW), Australia for a fall-related injury during 2000–01 to 2008–09, to examine the burden of fall-related inpatient rehabilitation hospital admissions from 1998–99 to 2010–11 and to estimate future demand for fall-related inpatient rehabilitation admissions in NSW to 2020. Method Retrospective review of sub-acute and non-acute records linked to hospital admission records during 2001–02 to 2008–09 in NSW. Analysis of temporal trends from 1998–99 to 2010–11 and projections to 2020 for rehabilitation-related (ICD-10-AM: Z47, Z48, Z50, Z75.1) inpatient hospital admissions. Results There were 4317 individuals with a fall-related injury admitted to hospital and subsequently admitted for sub-acute and non-acute care; 84% of these were aged 65+ years; 70.4% were female and 27.2% had femur fractures. For the rehabilitation-related admissions, total mean functional independence measure (FIM) scores improved significantly (from 78.4 to 94.6; P < 0.0001) between admission and discharge. Fall-related inpatient rehabilitation episodes increased by 9.1% each year between 1998 and 2011 for individuals aged 65 years and older and are projected to rise to 50 000 admissions annually by 2020. Conclusion This is the first study to provide an epidemiological profile of individuals using sub-acute and non-acute care in NSW using linked data. Improvements in data validity and reliability would enhance the quality of the sub-acute and non-acute care data and its ability to be used to inform resource use in this sector. The examination of temporal trends using only the inpatient hospital admissions provides a guide for resource implications for inpatient rehabilitation services. What is known about this topic? Fall-related injuries that result in inpatient hospital admissions are increasing in Australia. However, the extent of the effect of fall-related injuries in the sub-acute and non-acute sector remains unknown, due to data limitations. What does this paper add? Provides the first epidemiological profile of individuals who fall and go on to use sub-acute and non-acute care in NSW using linked data. It highlights where improvements in data quality in the sub-acute and non-acute care data could be made to improve their usefulness to inform resource use in this sector. What are the implications for clinicians? Fall injury prevention and healthy ageing strategies for older individuals remain a priority for clinicians. The current and projected future resource implications for inpatient rehabilitation and follow-up services provide an indication for clinicians of future demand in this area as the population ages. However, data quality needs to improve to provide clinicians with strongly relevant guidance to inform clinical practice.

scholarly journals 163 Morbidity of Presumed Temporary Loop De-Functioning Stomas in Patients with Colorectal Cancer

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
J Alfred ◽  
S Macdonald ◽  
R Kalaiselvan
Keyword(s):  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Single Centre ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Stoma Complications ◽  
Life Threatening ◽  
Picture Archiving And Communication ◽  
High Output

Abstract Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms, or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma. Method This was a retrospective cohort study of all left-sided colorectal cancer resections undertaken in a single centre. Electronic healthcare records and Picture Archiving and Communication System (PACS) were used to gather data on patient demographics, operative details and details of de-functioning stoma fashioned. Morbidity related to de-functioning stoma was determined based on hospital admissions and length of inpatient stay related to stoma, complications in relation to the stoma, return to theatre, stoma reversal and fate of stoma site. Results 147 patients (87 M; 60 F, median age 69 (23-93)) underwent left sided colorectal cancer resections at a single centre. In total, 50 de-functioning loop stomas were fashioned (49 loop ileostomies and 1 loop colostomy.) At a median follow-up of 23 months (8-44), prior to reversal, 12 PSH were identified. 38 of the de-functioning stomas were reversed at a median time of 11 months (1-44), 5 of which were emergency procedures due to obstruction (n = 3) or high output (n = 2). There were 9 stoma related re-admissions identified in 7 patients. Conclusions Presumed temporary defunctioning loop ileostomies in Low anterior resections is associated with significant morbidity, but low risk in terms of life-threatening complication.

EP.FRI.50 Morbidity of presumed temporary loop de-functioning stomas in patients with colorectal cancer

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Joshua Alfred ◽  
Siobhan Macdonald ◽  
Ramaya Kalaiselvan ◽  
Susanna Schuster Bruce
Keyword(s):  
Colorectal Cancer ◽  
Hospital Admissions ◽  
Single Centre ◽  
Patient Demographics ◽  
Emergency Procedures ◽  
Stoma Complications ◽  
Life Threatening ◽  
Picture Archiving And Communication ◽  
High Output

Abstract Objectives The incidence of parastomal hernia (PSH) can be up to 80% of patients who have a stoma following abdominal surgery (1). Surgical intervention is required in 70% of patients due to pain, obstructive symptoms or stoma appliance issues (2). This study aims to show the morbidity related to a presumed temporary loop stoma.  Methods This was a retrospective cohort study of all left-sided colorectal cancer resections undertaken in a single centre. Electronic healthcare records and Picture Archiving and Communication System (PACS) were used to gather data on patient demographics, operative details and details of de-functioning stoma fashioned. Morbidity related to de-functioning stoma was determined based on hospital admissions and length of inpatient stay related to stoma, complications in relation to the stoma, return to theatre, stoma reversal and fate of stoma site.  Results 147 patients (87 M; 60 F, median age 69 (23-93)) underwent left sided colorectal cancer resections at a single centre. In total, 50 de-functioning loop stomas were fashioned (49 loop ileostomies and 1 loop colostomy.) At a median follow-up of 23 months (8-44), prior to reversal, 12 PSH were identified. 38 of the de-functioning stomas were reversed at a median time of 11 months (1-44), 5 of which were emergency procedures due to obstruction (n = 3) or high output (n = 2). There were 9 stoma related re-admissions identified in 7 patients.  Conclusion Presumed temporary defunctioning loop ileostomies in Low anterior resections is associated with significant morbidity, but low risk in terms of life-threatening complication.

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