Unplanned hospitalizations in a racially and ethnically diverse population of women receiving chemotherapy for epithelial ovarian cancer

Shayan Dioun, Jennifer R. Jorgensen, Eirwen M. Miller, Joan Tymon-Rosario, Xianhong Xie, Xiaonan (Nan) Xue, Dennis Yi-Shin Kuo, Nicole S. Nevadunsky

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Abstract

Objectives: Unplanned hospital admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates of 10–35% for women with ovarian cancer receiving chemotherapy. We sought to evaluate the prevalence and associated risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, clinicopathologic and treatment data were abstracted from all patients with newly diagnosed epithelial ovarian cancer who received chemotherapy at our institution from 2005 to 2016. Two-sided statistical analyses and Cox regression analysis were performed using Stata. Results: Of 217 evaluable patients, 87 (40%) had unplanned admissions following chemotherapy: adjuvant 64 (74%) and neoadjuvant 23(26%). Thirty (14%) had more than one admission. In total, there were 1314 days of hospitalization. The median readmission duration was 3 days. Body mass index and hypertension were predictive of readmission (p < 0.05). When comparing those readmitted more than once to those admitted once, both race and aspirin use were predictive of readmission (p < 0.05). Of those admitted more than once the self-identified race and ethnicity was 12 (40%) Hispanic, 8 (27%) White, 8 (27%) Black and 2 (7%) other. There was a significant difference in disease free (p = 0.01) and overall survival (p = 0.004) for patients with unplanned admission after chemotherapy as compared to those without admission. Conclusions: Readmission rates in our racially diverse patient population were higher than previously reported in the literature. Identifying patients at risk of readmission may play a role in chemotherapy decision-making, and resource allocation including patient care navigators.

Original languageEnglish (US)
JournalGynecologic Oncology
DOIs
StateAccepted/In press - Jan 1 2018

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Hospitalization
Drug Therapy
Population
Patient Navigation
Urban Population
Resource Allocation
Quality of Health Care
Research Ethics Committees
Adjuvant Chemotherapy
Hispanic Americans
Ovarian Neoplasms
Aspirin
Ovarian epithelial cancer
Decision Making
Patient Care
Body Mass Index
Regression Analysis
Hypertension
Survival
Neoplasms

Keywords

  • Epithelial ovarian cancer
  • Hospital readmission after chemotherapy
  • Racially and ethnically diverse population

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

Cite this

@article{9983c7dd835849e082740b77c252edfb,
title = "Unplanned hospitalizations in a racially and ethnically diverse population of women receiving chemotherapy for epithelial ovarian cancer",
abstract = "Objectives: Unplanned hospital admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates of 10–35{\%} for women with ovarian cancer receiving chemotherapy. We sought to evaluate the prevalence and associated risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, clinicopathologic and treatment data were abstracted from all patients with newly diagnosed epithelial ovarian cancer who received chemotherapy at our institution from 2005 to 2016. Two-sided statistical analyses and Cox regression analysis were performed using Stata. Results: Of 217 evaluable patients, 87 (40{\%}) had unplanned admissions following chemotherapy: adjuvant 64 (74{\%}) and neoadjuvant 23(26{\%}). Thirty (14{\%}) had more than one admission. In total, there were 1314 days of hospitalization. The median readmission duration was 3 days. Body mass index and hypertension were predictive of readmission (p < 0.05). When comparing those readmitted more than once to those admitted once, both race and aspirin use were predictive of readmission (p < 0.05). Of those admitted more than once the self-identified race and ethnicity was 12 (40{\%}) Hispanic, 8 (27{\%}) White, 8 (27{\%}) Black and 2 (7{\%}) other. There was a significant difference in disease free (p = 0.01) and overall survival (p = 0.004) for patients with unplanned admission after chemotherapy as compared to those without admission. Conclusions: Readmission rates in our racially diverse patient population were higher than previously reported in the literature. Identifying patients at risk of readmission may play a role in chemotherapy decision-making, and resource allocation including patient care navigators.",
keywords = "Epithelial ovarian cancer, Hospital readmission after chemotherapy, Racially and ethnically diverse population",
author = "Shayan Dioun and Jorgensen, {Jennifer R.} and Miller, {Eirwen M.} and Joan Tymon-Rosario and Xianhong Xie and Xue, {Xiaonan (Nan)} and Kuo, {Dennis Yi-Shin} and Nevadunsky, {Nicole S.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.ygyno.2018.08.021",
language = "English (US)",
journal = "Gynecologic Oncology",
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TY - JOUR

T1 - Unplanned hospitalizations in a racially and ethnically diverse population of women receiving chemotherapy for epithelial ovarian cancer

AU - Dioun, Shayan

AU - Jorgensen, Jennifer R.

AU - Miller, Eirwen M.

AU - Tymon-Rosario, Joan

AU - Xie, Xianhong

AU - Xue, Xiaonan (Nan)

AU - Kuo, Dennis Yi-Shin

AU - Nevadunsky, Nicole S.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: Unplanned hospital admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates of 10–35% for women with ovarian cancer receiving chemotherapy. We sought to evaluate the prevalence and associated risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, clinicopathologic and treatment data were abstracted from all patients with newly diagnosed epithelial ovarian cancer who received chemotherapy at our institution from 2005 to 2016. Two-sided statistical analyses and Cox regression analysis were performed using Stata. Results: Of 217 evaluable patients, 87 (40%) had unplanned admissions following chemotherapy: adjuvant 64 (74%) and neoadjuvant 23(26%). Thirty (14%) had more than one admission. In total, there were 1314 days of hospitalization. The median readmission duration was 3 days. Body mass index and hypertension were predictive of readmission (p < 0.05). When comparing those readmitted more than once to those admitted once, both race and aspirin use were predictive of readmission (p < 0.05). Of those admitted more than once the self-identified race and ethnicity was 12 (40%) Hispanic, 8 (27%) White, 8 (27%) Black and 2 (7%) other. There was a significant difference in disease free (p = 0.01) and overall survival (p = 0.004) for patients with unplanned admission after chemotherapy as compared to those without admission. Conclusions: Readmission rates in our racially diverse patient population were higher than previously reported in the literature. Identifying patients at risk of readmission may play a role in chemotherapy decision-making, and resource allocation including patient care navigators.

AB - Objectives: Unplanned hospital admission following chemotherapy is a measure of quality cancer care. Large retrospective datasets have shown admission rates of 10–35% for women with ovarian cancer receiving chemotherapy. We sought to evaluate the prevalence and associated risk factors for hospital admission following chemotherapy in our racially diverse urban population. Methods: After IRB approval, clinicopathologic and treatment data were abstracted from all patients with newly diagnosed epithelial ovarian cancer who received chemotherapy at our institution from 2005 to 2016. Two-sided statistical analyses and Cox regression analysis were performed using Stata. Results: Of 217 evaluable patients, 87 (40%) had unplanned admissions following chemotherapy: adjuvant 64 (74%) and neoadjuvant 23(26%). Thirty (14%) had more than one admission. In total, there were 1314 days of hospitalization. The median readmission duration was 3 days. Body mass index and hypertension were predictive of readmission (p < 0.05). When comparing those readmitted more than once to those admitted once, both race and aspirin use were predictive of readmission (p < 0.05). Of those admitted more than once the self-identified race and ethnicity was 12 (40%) Hispanic, 8 (27%) White, 8 (27%) Black and 2 (7%) other. There was a significant difference in disease free (p = 0.01) and overall survival (p = 0.004) for patients with unplanned admission after chemotherapy as compared to those without admission. Conclusions: Readmission rates in our racially diverse patient population were higher than previously reported in the literature. Identifying patients at risk of readmission may play a role in chemotherapy decision-making, and resource allocation including patient care navigators.

KW - Epithelial ovarian cancer

KW - Hospital readmission after chemotherapy

KW - Racially and ethnically diverse population

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SN - 0090-8258

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