1640 - Are there factors that predict acute care admission in cancer patients age ≥65 years receiving chemotherapy? A retrospective analysis

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Geriatric Oncology
Palliative and Supportive Care
Presenter Mei Sim Lung
Authors M.S. Lung1, Y. Yeung2, C. Maddison2, A. Hutchinson2, S. White2
  • 1Northern Health, 3076 - Epping/AU
  • 2Medical Oncology, Northern Health, 3076 - Epping/AU

Abstract

Background

There is growing evidence that older patients derive the same benefits from chemotherapy as younger patients, but often at the cost of increased toxicity. A retrospective analysis was done of cancer patients ≥65 years who received chemotherapy, with the aim of identifying patient or treatment factors associated with subsequent hospital admission.

Methods

Medical records and an electronic prescribing system (EPS) were used to identify all cancer patients ≥65 years who received chemotherapy at Northern Health. For each patient, age, treatment dose at onset, ECOG, presence of metastases, cardiac comorbidities, chronic kidney disease stage, liver function tests and reason for admission were documented. Univariate and multivariate logistic regression analysis was used to assess the association between a factor and subsequent hospitalisation. An Odds Ratio greater than or less than 1, and a P value <0.05 were considered statistically significant.

Results

Between June 2009 and October 2010, 102 patients ≥65 years received chemotherapy on the EPS, which assigns full dose chemotherapy unless reduced by the clinician. 35 patients had a dose reduction at the outset. 49 patients were admitted following at least one cycle of chemotherapy; 33 (67%) for a treatment complication, 12 (24%) due to a cancer related complication and 4 (8%) for other reasons. After adjusting for age there was a trend for patients on full chemotherapy dose to have a decreased risk of admission (OR 0.50, 95%CI 0.21-1.12, p = 0.116). A multivariate model found that after adjusting for age and treatment dose, there was a trend for the presence of metastases at baseline (OR 2.6, 95%CI, 0.88-4.85, p = 0.095) and the presence of cardiac comorbidities (OR 2.35, 95%CI, 0.90-6.11, P = 0.080) to be associated with an increased risk of admission.

Conclusion

In this cohort of 102 older patients no factors were found that accurately predicted subsequent acute care admission. Surprisingly, a lack of dose reduction did not appear to incease risk of admission, indicating that high-risk patients were being effectively identified and that the EPS was being implemented appropriately in this population of older adults.

Disclosure

All authors have declared no conflicts of interest.