Unplanned hospitalizations in older patients with cancer: Occurrence and predictive factors.


Journal

Journal of geriatric oncology
ISSN: 1879-4076
Titre abrégé: J Geriatr Oncol
Pays: Netherlands
ID NLM: 101534770

Informations de publication

Date de publication:
04 2021
Historique:
received: 27 07 2020
revised: 27 10 2020
accepted: 13 11 2020
pubmed: 24 11 2020
medline: 29 7 2021
entrez: 23 11 2020
Statut: ppublish

Résumé

This study aims to investigate the occurrence of unplanned hospitalizations in older patients with cancer and to determine predictive factors. A prospective Belgian multicentre (n = 22), observational cohort study was performed. Patients ≥70 years with a malignant tumor were included. Patients underwent G8 screening followed by geriatric assessment (GA) if abnormal at baseline and were followed for unplanned hospitalizations at approximately three months. Uni- and multivariable regression models were performed to determine predictive factors associated with unplanned hospitalizations in older patients with an abnormal G8. In total, 7763 patients were included in the current analysis of which 2409 (31%) patients with a normal G8 score and 5354 (69%) with an abnormal G8 score. Patients with an abnormal G8 were hospitalized more frequently than patients with a normal G8 (22.9% versus 12.4%; p < 0.0001). Reasons for unplanned hospitalizations were most frequently cancer related (25.7%) or cancer therapy related (28%). In multivariable analysis, predictive factors for unplanned hospitalizations in older patients with cancer and an abnormal G8 were female gender, absence of surgery, chemotherapy, ADL dependency, malnutrition and presence of comorbidities. Older patients with cancer and an abnormal G8 screening present a higher risk (23%) for unplanned hospitalizations. Predictive factors for these patients were identified and include not only patient and treatment related factors but also GA related factors.

Sections du résumé

BACKGROUND
This study aims to investigate the occurrence of unplanned hospitalizations in older patients with cancer and to determine predictive factors.
METHODS
A prospective Belgian multicentre (n = 22), observational cohort study was performed. Patients ≥70 years with a malignant tumor were included. Patients underwent G8 screening followed by geriatric assessment (GA) if abnormal at baseline and were followed for unplanned hospitalizations at approximately three months. Uni- and multivariable regression models were performed to determine predictive factors associated with unplanned hospitalizations in older patients with an abnormal G8.
RESULTS
In total, 7763 patients were included in the current analysis of which 2409 (31%) patients with a normal G8 score and 5354 (69%) with an abnormal G8 score. Patients with an abnormal G8 were hospitalized more frequently than patients with a normal G8 (22.9% versus 12.4%; p < 0.0001). Reasons for unplanned hospitalizations were most frequently cancer related (25.7%) or cancer therapy related (28%). In multivariable analysis, predictive factors for unplanned hospitalizations in older patients with cancer and an abnormal G8 were female gender, absence of surgery, chemotherapy, ADL dependency, malnutrition and presence of comorbidities.
CONCLUSION
Older patients with cancer and an abnormal G8 screening present a higher risk (23%) for unplanned hospitalizations. Predictive factors for these patients were identified and include not only patient and treatment related factors but also GA related factors.

Identifiants

pubmed: 33223483
pii: S1879-4068(20)30496-3
doi: 10.1016/j.jgo.2020.11.004
pii:
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

368-374

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare no conflict of interest.

Auteurs

Elke Lodewijckx (E)

Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.

Cindy Kenis (C)

Department of General Medical Oncology and Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium.

Johan Flamaing (J)

Department of Geriatric Medicine, University Hospitals Leuven and Department of Chronic Diseases, Metabolism and Ageing - CHROMETA, KU Leuven, Leuven, Belgium.

Philip Debruyne (P)

Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium & Positive Ageing Research Institute (PARI), Anglia Ruskin University, Chelmsford, UK.

Inge De Groof (I)

Department of Geriatric Medicine, Iridium Cancer Network Antwerp, St. Augustinus, Wilrijk, Belgium.

Christian Focan (C)

Department of Oncology, Clinique Saint-Joseph, CHC-Liège Hospital Group, Liège, Belgium.

Frank Cornélis (F)

Department of Medical Oncology, Cliniques Universitaires Saint-Luc, UCL, Brussels, Belgium.

Vincent Verschaeve (V)

Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, Charleroi, Belgium.

Christian Bachmann (C)

Department of Geriatric Medicine, AZ Sint-Lucas, Gent, Belgium.

Dominique Bron (D)

Department of Hematology, ULB Institut Jules Bordet, Brussels, Belgium.

Sylvie Luce (S)

Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium.

Gwenaelle Debugne (G)

Department of Geriatric Medicine, Centre Hospitalier de Mouscron, Mouscron, Belgium.

Heidi Van den Bulck (H)

Department of Medical Oncology, Imelda Hospital, Bonheiden, Belgium.

Jean-Charles Goeminne (JC)

Department of Medical Oncology, CHU-UCL-Namur, site Sainte-Elisabeth, Namur, Belgium.

Dirk Schrijvers (D)

Department of Medical Oncology, ZNA Middelheim, Antwerp, Belgium.

Katrien Geboers (K)

Centre for Oncology and Hematology, AZ Turnhout, Turnhout, Belgium.

Benedicte Petit (B)

Department of Medical Oncology, Centre Hospitalier Jolimont, La Louvière, Belgium.

Christine Langenaeken (C)

Department Medical Oncology, Iridium Cancer Network Antwerp, AZ Klina, Brasschaat, Belgium.

Ruud Van Rijswijk (R)

Department Medical Oncology, ZNA Stuivenberg, Antwerp, Belgium.

Pol Specenier (P)

Department of Medical Oncology, University Hospital Antwerp, Antwerp, Belgium.

Guy Jerusalem (G)

Department of Medical Oncology, Centre Hospitalier Universitaire Sart Tilman and Liege University, Liege, Belgium.

Jean-Philippe Praet (JP)

Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, Brussels, Belgium.

Katherine Vandenborre (K)

Department of Medical Oncology, AZ Vesalius, Tongeren, Belgium.

Jean-Pierre Lobele (JP)

Consultant in Statistics, Beernem, Belgium.

Koen Milisen (K)

Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium.

Hans Wildiers (H)

Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, KU Leuven, Leuven, Belgium.

Lore Decoster (L)

Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. Electronic address: lore.decoster@uzbrussel.be.

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