Unplanned emergency department visits and hospital admissions of older adults under treatment for cancer in the ambulatory/community setting.

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Tytuł:: Unplanned emergency department visits and hospital admissions of older adults under treatment for cancer in the ambulatory/community setting.
Autorzy:: Loerzel VW; College of Nursing, University of Central Florida, 12201 Research Parkway, Suite 300, Orlando, FL, 32816, USA. .
Hines RB; College of Medicine, University of Central Florida, Orlando, FL, USA.
Deatrick CW; College of Nursing, University of Central Florida, 12201 Research Parkway, Suite 300, Orlando, FL, 32816, USA.
Geddie PI; Orlando Health, Orlando, FL, USA.
Clochesy JM; School of Nursing and Health Studies, University of Miami, Miami, FL, USA.
Źródło:: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2021 Dec; Vol. 29 (12), pp. 7525-7533. Date of Electronic Publication: 2021 Jun 09.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Berlin : Springer International, c1993-
MeSH Terms:: Hospitalization*
Neoplasms*/drug therapy
Neoplasms*/epidemiology
Aged ; Emergency Service, Hospital ; Hospitals ; Humans ; Retrospective Studies
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Contributed Indexing:: Keywords: Cancer; Emergency department visits; Hospital admissions; Older adults; Treatment-related side effects
Entry Date(s):: Date Created: 20210609 Date Completed: 20211028 Latest Revision: 20211028
Update Code:: 20240104
DOI:: 10.1007/s00520-021-06338-y
PMID:: 34105026
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Purpose: This study aims to identify the incidence and risk/protective factors for (1) unplanned emergency department (ED) visits and hospital admissions (HA) and (2) nausea/vomiting/dehydration (NVD) at time of treatment in older adults under treatment for cancer.
Materials and Methods: This is a exploratory retrospective cohort study of adults (60 and older) with cancer. Adults were included if they had a new cancer diagnosis and were being treated with chemotherapy. Study outcomes included the number of ED visits and HA (cycles 1-4) and NVD at the time of receiving chemotherapy (cycles 2-4). Repeated measures, Poisson regression was used to obtain risk ratios with 95% confidence intervals for independent predictors of outcomes.
Results: Of 402 study participants, 20% experienced an ED visit, and 18% experienced a HA. Common reasons for ED visits were pain (23.5%) and NVD (20.4%). Common reasons for HA were infection (34.4%) and NVD (22.2%). Multivariate analysis showed risk factors for ED visits included chemotherapy cycle 1, having esophageal cancer, being treated with ≥ 3 chemotherapy agents, and increasing levels of functional impairment. Risk factors for HA included chemotherapy cycle 1, increasing levels of functional impairment, intravenous fluids between treatment, and being prescribed antiemetics for home use. Predictors of NVD at time of chemotherapy treatment included Hispanic ethnicity, insurance status, cancer type, chemotherapy emetic potent, treatment frequency, intravenous fluids between cycles, and number of home antiemetics.
Conclusion: Unplanned ED visits and HA occur in older adults under treatment for cancer due to numerous treatment-related side effects. Helping older adults identify and manage side effects early may reduce the number of unplanned admissions.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

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