Cancer Radiation Therapy May Be Associated With Atrial Fibrillation

Background: The association of atrial fibrillation (AF) with cancer and cancer types is inconclusive. Similarly, data regarding the association of AF with different cancer therapies are controversial.Objectives: To study the association of AF with cancer subtypes and cancer therapies.Methods: We studied all patients aged 18–89 years who presented to the Feist Weiller Cancer Center, with or without a diagnosis of cancer, between January 2011 and February 2016. Electronic health records were systematically queried for baseline demographics and ICD-9 and ICD-10 codes for specific co-morbidities. Patients with a diagnosis of AF were tabulated based on cross-validation with the ECG database and/or by recorded history. We assessed the prevalence and risk of AF based on cancer diagnosis, specific cancer type, and cancer therapy.Results: A total of 14,600 patients were analyzed. Compared to non-cancer patients (n = 6,801), cancer patients (n = 7,799) had a significantly higher prevalence of AF (4.3 vs. 3.1%; p < 0.001). However, following correction for covariates in a multivariable logistic regression model, malignancy was not found to be an independent risk factor for AF (p = 0.32). While patients with solid tumors had a numerically higher prevalence of AF than those with hematological malignancies (4.3 vs. 4.1%), tumor type was not independently associated with AF (p = 0.13). AF prevalence was higher in patients receiving chemotherapy (4.1%), radiation therapy (5.1%), or both (6.9%) when compared to patients not receiving any therapy (3.6%, p = 0.01). On multivariable logistic regression, radiation therapy remained an independent risk factor for AF for the entire study population (p = 0.03) as well as for the cancer population (p < 0.01).Conclusions: Radiation therapy for cancer is an independent risk factor for AF. The known association between cancer and AF may be mediated, at least in part, by the effects of radiation therapy.

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Clinical Characteristics and Outcomes of Splenic Infarction in Cancer Patients - a Retrospective, Single Center Report of 206 Cases

Blood ◽

10.1182/blood-2020-136646 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 22-23

Author(s):

Jan Philipp Bewersdorf ◽

Nishita Parmar ◽

Scott Gettinger ◽

Gary Israel ◽

Alfred Ian Lee

Keyword(s):

Atrial Fibrillation ◽

Logistic Regression ◽

Cancer Patients ◽

Bivariate Analysis ◽

Single Center ◽

Risk Of Recurrence ◽

Vein Thrombosis ◽

Multivariable Logistic Regression ◽

Significant Difference ◽

The Impact

Introduction:Splenic infarct (SI) is caused by thromboembolic events or other local or systemic factors leading to insufficient splenic blood supply. One of the most common causes of SI is an underlying malignancy, which has been associated with nontraumatic SI in up to a third of cases. The incidence, underlying etiology, optimal treatment, and prognostic relevance of SI in cancer patients (pts) are poorly characterized with data limited to a few, retrospective, single center case series. Methods:We conducted a retrospective analysis of all radiologically-confirmed cases of SI in pts with any history of malignancy treated at Yale-New Haven Hospital during 2008-2017 to describe the incidence, treatment, and risk of recurrence of SI in cancer pts. Pediatric pts and cases of traumatic SI were excluded. Electronic medical records of eligible pts were reviewed and demographic, clinical, imaging and treatment characteristics as well as SI recurrence documented. Categorical and continuous variables among pts with and without recurrence of SI were compared using Pearson's χ2 test or Fisher's exact test and t-test with unequal variances, respectively. Multivariable logistic regression models that included variables associated with a higher risk of SI recurrence at a p-value of <0.2 in bivariate analysis were conducted to evaluate the impact of those variables on SI recurrence. Results:206 pts were included in the analysis with baseline characteristics shown inTable 1.Thirty-four pts (16.5%) had a prior venous thromboembolic event (VTE), while 40 pts (19.5%) had been on anticoagulation (AC) for other indications at the time of SI. Diagnosis of SI was often made incidentally on CT or MRI during routine cancer surveillance (44.2%; n = 91) or initial cancer staging (5.8%; n = 12). Splenomegaly was present in 33% of cases (n = 68) with 90.8% of pts (n = 188) having an unremarkable splenic vasculature. Abnormalities in the splenic vasculature included splenic artery/vein thrombosis (2.9%; n = 6) or occlusion (1.5%; n = 3), external compression by local tumor (1.5%; n = 3), direct tumor invasion into the splenic vasculature (2.9%; n = 6), and portal vein thrombosis (4.9%; n = 10). Following a diagnosis of SI, 22 pts (10.7%) were newly started on therapeutic AC and 36 pts (17.5%) continued on previously prescribed AC. Compared to those who were not anticoagulated, pts who were started or continued on AC after their diagnosis of SI were statistically more likely to have atrial fibrillation/flutter (29.3% vs. 12.2%; p = 0.003) or to have had a prior VTE (46.6% vs. 4.7%; p < 0.001). Pts newly started on AC following SI were more likely to have had a prior VTE (27.2% vs. 4.7%; p < 0.001) compared to pts who did not receive AC without a statistically significant difference in the rates of atrial fibrillation/flutter (22.7% vs. 12.2%; p = 0.186). Five of the 22 pts (22.7%) initiated on and five of the 36 pts (13.9%) continued on AC developed a subsequent VTE, respectively. There was no statistically significant difference in the risk of subsequent VTE among pts who continued or initiated AC compared to pts who did not receive AC (17.2% [10 out of 58 pts] vs. 12.8% [19 out of 148 pts]; p = 0.414). Follow-up imaging was available for 152 of the 206 pts (73.8%). A recurrent or enlarging SI was detected in 6 pts (4.0%) at a median of 35 days following initial SI (range: 8-734 days). Anticoagulation was not associated with a reduction in the risk of subsequent SI. In bivariate analysis none of the baseline patient, treatment, or imaging characteristics were statistically significantly associated with a higher chance of SI recurrence, although prior and subsequent VTE (p = 0.063) and atrial fibrillation/flutter (p = 0.076) showed trends towards statistical significance (Table 2). In a multivariable logistic regression model, no variables were identified that were associated with a higher risk of SI recurrence. Conclusion:In this large retrospective study of 206 cancer pts with SI, we showed that SI in this patient population are often an incidental finding with low risk of recurrence that is not impacted by AC. SI recurrence in cancer pts has a nonsignificant association with atrial fibrillation and prior VTE and therefore might arise as a cardioembolic event or as part of the underlying hypercoagulable state of malignancy. Additional prospective studies are needed to evaluate the risk and benefits of AC in this setting. Disclosures No relevant conflicts of interest to declare.

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AF in Cancer Patients: A Different Need for Anticoagulation?

European Cardiology Review ◽

10.15420/ecr.2018.32.2 ◽

2019 ◽

Vol 14 (1) ◽

pp. 65-67 ◽

Cited By ~ 4

Author(s):

Ana Pardo Sanz ◽

José Luis Zamorano Gómez

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

General Population ◽

Cancer Patients ◽

Bleeding Risk ◽

The Other ◽

Risk Scores ◽

Cancer Therapies ◽

Lack Of Information ◽

Oncologic Patients

Cancer and cancer therapies might be a risk factor for developing Atrial Fibrillation (AF). It remains unclear if one is the cause or consequence of the other, or if they simply coexist. An unpredictable response to anticoagulation can be expected, as a result of the lack of information in oncology patients. The balance between thromboembolic and bleeding risks of AF in these patients is particularly challenging. Little is known about whether embolic and bleeding risk scores used for the general population can be applied in oncologic patients. Cardiology involvement in the management of these patients seems to be associated with favourable AF-related outcomes.

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Predictive Values of Inflammation-Related Markers and Thyroid Function in Pediatric Thyroid Cancer Patients

Frontiers in Pediatrics ◽

10.3389/fped.2021.802214 ◽

2021 ◽

Vol 9 ◽

Author(s):

Shuo Li ◽

Yihao Liu ◽

Shaoxuan Liu ◽

Gongbo Du ◽

Zipeng Wang ◽

...

Keyword(s):

Logistic Regression ◽

Risk Factor ◽

Thyroid Cancer ◽

Cancer Patients ◽

Thyroid Function ◽

Independent Risk Factor ◽

Thyroid Nodules ◽

Pediatric Patients ◽

Predictive Values ◽

Pediatric Thyroid Cancer

Few researchers have studied the diagnostic value of inflammation-related hematological indexes of pediatric thyroid carcinoma exclusively. Whether thyroid-stimulating hormone (TSH) is an independent risk factor for pediatric thyroid cancer is still controversial. To assess the correlativity and predictive values of inflammation-related markers and thyroid function in pediatric thyroid cancer patients, we collected a total of 270 children with thyroid nodules for two consecutive years. Clinical data including age, gender, thyroid function, inflammation indexes, and clinical pathologic finding were collected and analyzed. The above-mentioned data were compared between the benign group and the malignant group, followed by the subgroups comparison. Binary logistic regression analysis was used to evaluate the correlation of markers and the pathological features of thyroid nodules. The neutrophil-to-lymphocyte ratio (NLR) showed a significant difference between thyroid cancer and thyroid nodules, while TSH did not. NLR > 1.49529 was the prognostic indicator of pediatric thyroid cancer. The logistic regression model further revealed that NLR > 1.49529 was an independent risk factor for thyroid cancer in pediatric patients. Furthermore, TSH was not correlated with the tumor characteristics in the thyroid cancer group. In conclusion, the findings in this study showed that NLR could be a predictor of thyroid cancer in pediatric patients and refuted the present view that TSH is a risk factor in pediatric thyroid cancer.

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P1571Atrial fibrillation is an independent predictor of mortality in hospitalized cancer patients

European Heart Journal ◽

10.1093/eurheartj/ehz748.0331 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A H Malik ◽

S Shetty ◽

S Malik

Keyword(s):

Atrial Fibrillation ◽

Colon Cancer ◽

Risk Factor ◽

Hospital Mortality ◽

Cancer Patients ◽

Cancer Diagnosis ◽

Independent Risk Factor ◽

Attributable Mortality ◽

Patients With Cancer ◽

Hospitalised Patients

Abstract Background Atrial fibrillation (AF) is prevalent in patients with cancer. We performed a study to evaluate the outcomes associated with hospitalised cancer patients with AF. Methods The Nationwide Inpatient Sample was used to identify patients with a cancer diagnosis, who were found to have atrial fibrillation from the years 2002–2014. Descriptive statistics for mortality were calculated using univariate and multivariate model for each cancer, and we identified the type of cancer associated with the highest inpatient mortality. We also calculated the percentage of hospital mortality attributable to AF. Results 12,410,290 (nationwide estimate) patients with a cancer diagnosis were identified, and 8.2% of them had AF. In a multivariate adjusted model for various relevant comorbidities, age, gender and race, AF was also found to be an independent risk factor for higher in-hospital mortality in cancer patients, odds ratio (OR) 1.25 (95% CI 1.23, 1.28, p<0.0001). Colon cancer was found to be associated with the worst outcomes and the highest mortality. In cancer patients, the incident percentage of hospital mortality attributed to AF was 46.7%, population attributable mortality risk of was 7.17%, and number needed to harm was 21 (p<0.0001). Conclusion AF conferred significant morbidity and was found to be an independent risk factor for increased mortality in hospitalised patients with cancer. Colon cancer was found to have the strongest association of worst outcomes in hospitalized patients with AF. Acknowledgement/Funding None

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Clinical risk predictors for bradycardia, supraventricular tachycardia and epilepsy necessitating therapy in patients with unexplained syncope monitored by insertable cardiac monitor

European Heart Journal ◽

10.1093/ehjci/ehaa946.0709 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

T Onuki ◽

M Shoji ◽

M Kikuchi ◽

T Asano ◽

H Suzuki ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Logistic Regression ◽

Regression Analysis ◽

Risk Factor ◽

Independent Risk Factor ◽

Sick Sinus Syndrome ◽

Unexplained Syncope ◽

Independent Risk Factors

Abstract Background Insertable cardiac monitors (ICMs) allow for lengthy monitoring of cardiac rhythm and improve diagnostic yield in patients with unexplained syncope. In most cardiac syncope cases, sick sinus syndrome, atrioventricular block, and paroxysmal supraventricular tachycardia (SVT) are detected using ICMs. On the other hand, epileptic seizures are sometimes diagnosed as unexplained syncope because in these situations, the loss of consciousness is a similar manifestation. Thus, the population of patients with unexplained syncope monitored by ICMs includes epileptic patients. Clinical risk factors for bradycardia, SVT and epilepsy that necessitate therapy in patients with unexplained syncope are not well known. If these risks can be clarified, clinicians could provide more specific targeted monitoring. Purpose We aimed to identify these predictors. Methods We retrospectively reviewed medical records of consecutive patients who received ICMs to monitor unexplained syncope in three medical facilities. We performed Cox's stepwise logistic regression analysis to identify significant independent risk factors for bradycardia, SVT, and epilepsy. Results One hundred thirty-two patients received ICMs to monitor unexplained syncope. During the 17-month follow-up period, 19 patients (10 patients had sick sinus syndrome and 9 had atrioventricular block) needed pacemaker for bradycardia; 8 patients (3 had atrial flutter, 4 had atrial tachycardia, and 1 had paroxysmal atrial fibrillation) needed catheter ablation for SVT; and 9 patients needed antiepileptic agents from the neurologist.Stepwise logistic regression analysis indicated that syncope during effort (odds ratio [OR] = 3.41; 95% confidence interval [CI], 1.21 to 9.6; p=0.02) was an independent risk factor for bradycardia. Palpitation before syncope (OR = 9.46; 95% CI, 1.78 to 50.10; p=0.008) and history of atrial fibrillation (OR = 10.1; 95% CI, 1.96 to 52.45; p=0.006) were identified as significant independent prognostic factors for SVT. Syncope while supine (OR = 11.7; 95% CI, 1.72 to 79.7; p=0.01) or driving (OR = 15.6; 95% CI, 2.10 to 115.3; p=0.007) was an independent factor for epileptic seizure. Conclusions ICMs are useful devices for diagnosing unexplained syncope. Palpitation, atrial fibrillation and syncope during effort were independent risk factors for bradycardia and for SVT. Syncope while supine or driving was an independent risk factor for epilepsy. We should carefully follow up of patients with these risk factors. Funding Acknowledgement Type of funding source: None

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P6535Atrial fibrillation and its impact in hospitalised cancer patients

European Heart Journal ◽

10.1093/eurheartj/ehz746.1125 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A H Malik ◽

N Siddiqui ◽

S Shetty ◽

A Godara ◽

Z Khan ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Factor ◽

Confidence Interval ◽

Hospital Mortality ◽

Cancer Patients ◽

Odds Ratio ◽

Independent Risk Factor ◽

Multivariate Model ◽

P Value ◽

Patients With Cancer

Abstract Background Atrial fibrillation (AF) is associated with increased morbidity and mortality. However, its impact on outcomes of cancer patients is largely unknown. We sought to determine the prevalence and effect of AF on in-hospital outcomes of patients admitted with AF in the United States. Methods We obtained and analyzed data from Nationwide Inpatient Sample (NIS 2002- 2014). The study population included all adults (>18 years old) with the discharge diagnosis of cancer and the associated secondary diagnosis of AF. The associations of AF with in-hospital complications, procedures, discharge outcomes, and mortality, were analyzed after adjusting for potential confounders using logistic regression analyses. Results During the study period, 12,410,290 patients were admitted with cancer; of which, 1,013,735 (8.2%) had AF. Patients with AF were likely to be male (51.1% vs 42.7%), white (86.3% vs 73.6%), and had significantly higher rates comorbidities including hypertension (59.6% vs 44.6%), diabetes (20.9% vs 15.8%), heart failure (23.8% vs 4.5%), and stroke (1.3% vs 0.7%). Similarly, in-hospital complications (including infections, venous thromboembolism, gastrointestinal bleeding, myocardial infarction) and hospital procedures (including cardiac catheterization, intubation, blood transfusion, percutaneous coronary intervention) were found at a significantly higher rate in cancer patients with AF compared to without AF (p-value for all <0.0001). After adjusting for all confounding factors, cancer patients in the AF group had higher odds of in-hospital death (odds ratio, 1.26; 95% confidence interval, 1.23–1.28; P<0.0001). The presence of AF conferred on average three days of extra inpatient stay in patients with cancer. Mortality in the cancer patients admitted with a concomitant diagnosis of AF has gradually increased from 7.2% to 9.7% over the 13-year study period. Table 1. Multivariate model showing Atrial fibrillation as an independent risk factor of inpatient mortality in cancer patients Unadjusted univariate model Multivariate model adjusted for age, sex, race and potential confounders* Odds ratio (95% confidence interval P-value Odds ratio (95% confidence interval P-value Discharged alive Reference Reference In-hospital mortality 2.08 (2.07, 2.10) <0.0001 1.26 (1.23, 1.28) <0.0001 *Confounders adjusted for include all clinical comorbidities and in-hospital complications and procedures. Conclusions In patients with cancer, AF confers significant in-hospital burden by increasing the hospital stay by 3 days. AF is also associated with significantly higher rates of in-hospital procedures and complications in cancer patients and is an independent risk factor of in-hospital mortality. Acknowledgement/Funding None

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Efficacy and safety of 5 mg olanzapine for nausea and vomiting management in cancer patients receiving carboplatin: integrated study of three prospective multicenter phase II trials

BMC Cancer ◽

10.1186/s12885-021-08572-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Senri Yamamoto ◽

Hirotoshi Iihara ◽

Ryuji Uozumi ◽

Hitoshi Kawazoe ◽

Kazuki Tanaka ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Cancer Patients ◽

Phase Ii ◽

Low Dose ◽

Nausea And Vomiting ◽

Efficacy And Safety ◽

Multivariable Logistic Regression ◽

Related Risk ◽

Total Control

Abstract Background The efficacy of olanzapine as an antiemetic agent in cancer chemotherapy has been demonstrated. However, few high-quality reports are available on the evaluation of olanzapine’s efficacy and safety at a low dose of 5 mg among patients treated with carboplatin regimens. Therefore, in this study, we investigated the efficacy and safety of 5 mg olanzapine for managing nausea and vomiting in cancer patients receiving carboplatin regimens and identified patient-related risk factors for carboplatin regimen-induced nausea and vomiting treated with 5 mg olanzapine. Methods Data were pooled for 140 patients from three multicenter, prospective, single-arm, open-label phase II studies evaluating the efficacy and safety of olanzapine for managing nausea and vomiting induced by carboplatin-based chemotherapy. Multivariable logistic regression analyses were performed to determine the patient-related risk factors. Results Regarding the endpoints of carboplatin regimen-induced nausea and vomiting control, the complete response, complete control, and total control rates during the overall study period were 87.9, 86.4, and 72.9%, respectively. No treatment-related adverse events of grade 3 or higher were observed. The multivariable logistic regression models revealed that only younger age was significantly associated with an increased risk of non-total control. Surprisingly, there was no significant difference in CINV control between the patients treated with or without neurokinin-1 receptor antagonist. Conclusions The findings suggest that antiemetic regimens containing low-dose (5 mg) olanzapine could be effective and safe for patients receiving carboplatin-based chemotherapy.

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Should the Presence or Extent of Coronary Artery Disease be Quantified in the CHA2DS2-VASc Score in Atrial Fibrillation? A Report from the Western Denmark Heart Registry

Thrombosis and Haemostasis ◽

10.1055/s-0038-1675401 ◽

2018 ◽

Vol 118 (12) ◽

pp. 2162-2170 ◽

Cited By ~ 11

Author(s):

Kamilla Steensig ◽

Kevin Olesen ◽

Troels Thim ◽

Jens Nielsen ◽

Svend Jensen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Coronary Artery Disease ◽

Risk Factor ◽

Coronary Artery ◽

Coronary Angiography ◽

Ischaemic Stroke ◽

Independent Risk Factor ◽

Oral Anticoagulants ◽

Increased Risk ◽

Artery Disease

Background Patients with atrial fibrillation (AF) have an increased risk of ischaemic stroke. The risk can be predicted by the CHA2DS2-VASc score, in which the vascular component refers to previous myocardial infarction, peripheral artery disease and aortic plaque, whereas coronary artery disease (CAD) is not included. Objectives This article explores whether CAD per se or extent provides independent prognostic information of future stroke among patients with AF. Materials and Methods Consecutive patients with AF and coronary angiography performed between 2004 and 2012 were included. The endpoint was a composite of ischaemic stroke, transient ischaemic attack and systemic embolism. The risk of ischaemic events was estimated according to the presence and extent of CAD. Incidence rate ratios (IRR) were calculated in reference to patients without CAD and adjusted for parameters included in the CHA2DS2-VASc score and treatment with anti-platelet agents and/or oral anticoagulants. Results Of 96,430 patients undergoing coronary angiography, 12,690 had AF. Among patients with AF, 7,533 (59.4%) had CAD. Mean follow-up was 3 years. While presence of CAD was an independent risk factor for the composite endpoint (adjusted IRR, 1.25; 1.06–1.47), extent of CAD defined as 1-, 2-, 3- or diffuse vessel disease did not add additional independent risk information. Conclusion Presence, but not extent, of CAD was an independent risk factor of the composite thromboembolic endpoint beyond the components already included in the CHA2DS2-VASc score. Consequently, we suggest that significant angiographically proven CAD should be included in the vascular disease criterion in the CHA2DS2-VASc score.

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Outcomes for and Risk Factors Associated With Vancomycin-ResistantEnterococcus faecalisand Vancomycin-ResistantEnterococcus faeciumBacteremia in Cancer Patients

Infection Control and Hospital Epidemiology ◽

10.1086/519932 ◽

2007 ◽

Vol 28 (9) ◽

pp. 1054-1059 ◽

Cited By ~ 47

Author(s):

G. Ghanem ◽

R. Hachem ◽

Y. Jiang ◽

R. F. Chemaly ◽

I. Raad

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Mortality Rate ◽

Cancer Patients ◽

Independent Risk Factor ◽

Response To Therapy ◽

Aminoglycoside Therapy ◽

Significant Difference ◽

Vancomycin Resistant ◽

And Control

Objective.Vancomycin-resistant enterococci (VRE) are a major cause of nosocomial infection. We sought to compare vancomycin-resistant (VR)Enterococcus faecalisbacteremia and VREnterococcus faeciumbacteremia in cancer patients with respect to risk factors, clinical presentation, microbiological characteristics, antimicrobial therapy, and outcomes.Methods.We identified 210 cancer patients with VRE bacteremia who had been treated between January 1996 and December 2004; 16 of these 210 had VRE. faecalisbacteremia and were matched with 32 patients with VRE. faeciumbacteremia and 32 control patients. A retrospective review of medical records was conducted.Results.Logistic regression analysis showed that, compared with VRE. faecalisbacteremia, VRE. faeciumbacteremia was associated with a worse clinical response to therapy (odds ratio [OR], 0.3 [95% confidence interval (CI), 0.07-0.98];P= .046) and a higher overall mortality rate (OR, 8.3 [95% CI, 1.9-35.3];P= .004), but the VRE-related mortality rate did not show a statistically significant difference (OR, 6.8 [95% CI, 0.7-61.8];P= .09). Compared with control patients, patients with VRE. faecalisbacteremia were more likely to have received an aminoglycoside in the 30 days before the onset of bacteremia (OR, 5.8 [95% CI, 1.2-27.6];P= .03), whereas patients with VRE. faeciumbacteremia were more likely to have received a carbapenem in the 30 days before the onset of bacteremia (OR, 11.7 [95% CI, 3.6-38.6];P<.001). In a multivariate model that compared patients with VRE. faeciumbacteremia and control patients, predictors of mortality included acute renal failure on presentation (OR, 15.1 [95% CI, 2.3-99.2];P= .004) and VRE. faeciumbacteremia (OR, 11 [95% CI, 2.7-45.1];P<.001). No difference in outcomes was found between patients with VRE. faecalisbacteremia and control patients.Conclusions.VRE. faeciumbacteremia in cancer patients was associated with a poorer outcome than was VRE. faecalisbacteremia. Recent receipt of carbapenem therapy was an independent risk factor for VRE. faeciumbacteremia, and recent receipt of aminoglycoside therapy was independent risk factor forE. faecalisbacteremia.

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Evaluation of Subjective Sleep Disturbances in Cancer Patients: A Cross-Sectional Study in a Radiotherapy Department

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.648896 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jun Wang ◽

Bei-Yun Zhou ◽

Chen-Lu Lian ◽

Ping Zhou ◽

Hui-Juan Lin ◽

...

Keyword(s):

Logistic Regression ◽

Sleep Quality ◽

Sleep Disturbance ◽

Sleep Disorders ◽

Cancer Patients ◽

Sleep Disturbances ◽

Cancer Type ◽

Multivariate Logistic Regression ◽

Subjective Sleep ◽

Radiotherapy Department

Background: The factors associated with sleep disturbances in cancer patients remains unclear. This study aimed to explore the prevalence of sleep disorders and predictors associated with sleep disturbance in cancer patients from a radiotherapy department.Methods: Patients with cancers were recruited before the start of radiotherapy from our institution between January 2019 and February 2020. Pittsburgh Sleep Quality Index (PSQI) scale was used to assess sleep quality. Descriptive statistics, Chi-square test, and multivariate logistic regression analysis were used to conduct statistical analysis.Results: A total of 330 eligible patients were included. Of them, 38.3% (n = 127) had the globe PSQI score >7, indicating that they suffered from sleep disorders. Patients with lung cancer (45.2%) were more likely to suffer from sleep disturbance, followed by cervical cancer (43.8%), nasopharyngeal carcinoma (41.7%), esophageal cancer (41.5%), breast cancer (37.7%), and colorectal cancer (30%). With regard to the PSQI components, the mean sleep duration was 8 h, 20.3% (n = 67) of them reported poor subjective sleep quality, 6.1% (n = 20) needed medication to improve sleep, and 53.6% (n = 177) suffered daytime dysfunction. Multivariate logistic regression models showed body mass index (BMI) ≥ 20 kg/m2 [odds ratio (OR) 0.599, 95% confidence interval (CI) 0.329–0.948, P = 0.031] and the receipt of surgery (OR 0.507, 95% CI 0.258–0.996, P = 0.048) were the significant favorable predictors for sleep disturbance, while age, gender, marital status, education level, comorbidity, metastasis status, diagnostic status, and cancer type were not significantly associated with sleep disturbance.Conclusions: Approximately 40% of the cancer patients suffer from sleep disturbance before the start of radiotherapy. Patients with BMI ≥ 20 kg/m2 and receiving surgery are less likely to develop sleep disturbance in comparison with others.

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