ReCAP: Hospitalizations in Older Adults With Advanced Cancer: The Role of Chemotherapy [CARE DELIVERY]

CONCLUSION: Hospitalizations are common in patients with incurable advanced malignancies and are more likely among those who receive chemotherapy. APPROACH: In the linked SEER-Medicare dataset, we identified Medicare beneficiaries aged 66 years or older with a primary diagnosis of metastatic breast, colorectal, ovarian, bladder, lung, pancreas, esophageal, stomach, or prostate cancer between 2001 and 2009 who died by the end of 2010. Chemotherapy recipients and nonrecipients were pair-matched by age, sex, race, comorbidity, geographic region and survival duration. The primary endpoint was hospital admission, identified in inpatient claims between cancer diagnosis and the first of hospice admission or death. We also identified the subset of admissions associated with a primary or secondary diagnosis code suggestive of an adverse effect of chemotherapy. The association between chemotherapy and hospitalization was estimated in separate multivariable Cox proportional-hazards regression models for each cancer site, accounting for the matched-pairs design and controlling for unmatched demographic and disease characteristics. RESULTS: Of 18,486 patients who received chemotherapy for metastatic cancer, 92% were hospitalized at least once for any reason, including 51% hospitalized for a likely toxicity. The corresponding rates among matched non-recipients were 83% and 34% (Figure). In nearly all cancers, chemotherapy recipients had a greater risk of hospitalization for a likely toxi...
Source: Journal of Oncology Practice - Category: Cancer & Oncology Authors: Tags: Older adult (geriatrics), Complications of cancer and cancer treatment, Population and Observational Studies, Outcomes Research, Outcomes Research CARE DELIVERY Source Type: research