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ePoster Display

1724P - Prognostic parameters at admission as predictors of hospital length of stay (HLOS) and overall survival (OS) in hospitalized oncologic patients (pts) of a tertiary hospital

Date

16 Sep 2021

Session

ePoster Display

Presenters

Oriol Mirallas

Citation

Annals of Oncology (2021) 32 (suppl_5): S1175-S1198. 10.1016/annonc/annonc714

Authors

O. Mirallas1, D. López-Valbuena1, G. Villacampa Javierre2, K.S. Vega1, D. Gómez-Puerto3, C. Salva-Torres1, A. Rezqallah1, G. Molina1, J. Aguilar-Company1, M. Roca1, L. Andurell1, F. Palmas4, M.E. Elez Fernandez1, A. Alonso1, P. Gomez-Pardo1, S. Serradell1, J. Tabernero1, E. Felip1, A. Peñuelas1, J. Carles1

Author affiliations

  • 1 Medical Oncology Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
  • 2 Statistics Department, Vall d'Hebron Institute of Oncology (VHIO)-Cellex Center, 08035 - Barcelona/ES
  • 3 Medical Oncology Department, Vall d'Hebron University Hospital, 08035 - Barcelona/ES
  • 4 Nutrition Department, Vall d'Hebron University Hospital, 8035 - Barcelona/ES
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Abstract 1724P

Background

Prognostic factors for oncologic pts after surgery or curative systemic treatment have been described, including malnutrition, ECOG status or tumour staging. However, there is no solid evidence on which parameters predict outcomes after hospitalization of unselected cancer pts.

Methods

Prospective study of all pts hospitalized between Feb and Dec 2020 at Vall d’Hebron Hospital (PLANTOLOGY database) was analysed. Clinical factors such as ECOG, comorbidities and analytical parameters were collected at admission. Mental status and QOL were assessed by the HADS and EORTC-QLQ30 questionnaires, respectively. HLOS and overall survival (OS) since the first day of admission were calculated with the Kaplan-Meier method and univariate and multivariate Cox models were fitted to estimate hazard ratios (HR) with CI 95%.

Results

Among 772 hospitalized pts, median age was 66 years, 57.9% were active smokers and 51.4% had an ECOG ≤1. Most frequent tumour types were lung (17.2%) and colorectal (9.8%), median Charlson comorbidity index was 8 (IQR 2 - 15) and 28.4% were treated under clinical trial prior to admission. Median follow-up time was 9.5 months (m). Median HLOS was 9 days (CI95% 8 - 10) and median OS was 5.2 m (CI95 % 4.7–6). The most relevant factors associated with longer HLOS at admission were EOTC-QLQ30 ≥65, albumin <3 g/dL and HOSPITAL score >6 (all p-values p <0.001). In OS analysis, several factors were associated with worse OS (all p-values <0.05). In the multivariable analysis, the most parsimonious model included five factors: HADS, ECOG, cancer stage, LDH and albumin levels. HADS depression scale ≥9 was an independent factor for worse OS (HR 1.87; CI95 % 1.31 – 2.66; <0.001). A prognostic multivariate calculator was built to predict OS with the selected variables (C-statistics = 0.68).

Conclusions

Multiple predictor factors at admission help us predict the HLOS and OS of hospitalised oncologic pts. The quality of life, hospital score and nutritional status predicted a longer HLOS, while disease aggressiveness, nutritional status and depression predicted a worse OS. Despite pts heterogeneity, our prognostic calculator may help guide clinical decisions by risk stratification.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Vall d'Hebron Institute of Oncology (VHIO).

Funding

Has not received any funding.

Disclosure

O. Mirallas: Financial Interests, Personal, Invited Speaker: Rovi; Financial Interests, Personal, Invited Speaker: Roche; Financial Interests, Personal, Invited Speaker: Kyowa Kirin; Financial Interests, Personal, Invited Speaker: Grupo Pacifico. M.E. Elez Fernandez: Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: Array Biopharma; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Hoffman La-Roche; Financial Interests, Personal, Advisory Board: Merck Serono; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Servier. J. Tabernero: Financial Interests, Personal, Advisory Role: Array Biopharma; Financial Interests, Personal, Advisory Role: AstraZeneca; Financial Interests, Personal, Advisory Role: Avvinity; Financial Interests, Personal, Advisory Role: Bayer; Financial Interests, Personal And Institutional, Advisory Role: Boehringer Ingelheim; Financial Interests, Personal, Advisory Role: Chugai; Financial Interests, Personal, Advisory Role: Daiichi Sankyo; Financial Interests, Personal, Advisory Role: F. Hoffmann-La Roche Ltd; Financial Interests, Personal And Institutional, Advisory Role: Genetech Inc; Financial Interests, Personal And Institutional, Advisory Role: Haliodx Sas; Financial Interests, Personal And Institutional, Advisory Role: Hutchinson Medpharma International; Financial Interests, Personal, Advisory Role: Ikena Oncology; Financial Interests, Personal, Advisory Role: IQVIA; Financial Interests, Personal, Advisory Role: Lilly; Financial Interests, Personal, Advisory Role: Menarini; Financial Interests, Personal, Advisory Role: Merck Serono; Financial Interests, Personal And Institutional, Advisory Role: Merus; Financial Interests, Personal, Advisory Role: MSD; Financial Interests, Personal And Institutional, Advisory Role: Mirati; Financial Interests, Personal, Advisory Role: Neophore; Financial Interests, Institutional, Funding: Amgen Inc; Financial Interests, Institutional, Funding: Array Biopharma; Financial Interests, Institutional, Funding: AstraZeneca; Financial Interests, Institutional, Funding: Beigene; Financial Interests, Institutional, Funding: Bristol Myers Squibb; Financial Interests, Institutional, Funding: Celgene; Financial Interests, Institutional, Funding: Debiopharm International; Financial Interests, Institutional, Funding: F. Hoffman-La Roche; Financial Interests, Institutional, Funding: Janssen-Cilag SA; Financial Interests, Institutional, Funding: Medimmune; Financial Interests, Institutional, Funding: Merck Health; Financial Interests, Institutional, Funding: Novartis. E. Felip: Financial Interests, Personal, Advisory Board: Amgen; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Advisory Board: Beigene; Financial Interests, Personal, Advisory Board: Boehringer Ingelheim; Financial Interests, Personal, Advisory Board: Bristol-Myers Squibb; Financial Interests, Personal, Advisory Board: Eli Lilly; Financial Interests, Personal, Advisory Board: F.Hoffman-La Roche; Financial Interests, Personal, Advisory Board: Janssen; Financial Interests, Personal, Advisory Board: Medical Trends; Financial Interests, Personal, Advisory Board: Merck Sharp & Dohme; Financial Interests, Personal, Advisory Board: Peptomyc; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Puma; Financial Interests, Personal, Advisory Board: Regeneron; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Personal, Advisory Board: Syneos Health; Financial Interests, Personal, Advisory Board: Takeda. J. Carles: Financial Interests, Personal, Advisory Board: Astellas Pharma; Financial Interests, Personal, Advisory Board: AstraZeneca; Financial Interests, Personal, Advisory Board: Bayer; Financial Interests, Personal, Advisory Board: Bristol Myers Squibb; Financial Interests, Personal, Advisory Board: Johnson&Johnson; Financial Interests, Personal, Advisory Board: MSD Oncology; Financial Interests, Personal, Advisory Board: Novartis; Financial Interests, Personal, Advisory Board: Pfizer; Financial Interests, Personal, Advisory Board: Roche; Financial Interests, Personal, Advisory Board: Sanofi; Financial Interests, Institutional, Funding: Janssen-Cilag; Financial Interests, Institutional, Funding: Laboratories Leurquin Mediolanum. All other authors have declared no conflicts of interest.

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