Natalia M Pittman1, Wilma M Hopman1, Mihaela Mates2. 1. Cancer Centre of Southeastern Ontario at Kingston General Hospital; Queen's University; and Kingston General Hospital Clinical Research Centre, Kingston, Ontario, Canada. 2. Cancer Centre of Southeastern Ontario at Kingston General Hospital; Queen's University; and Kingston General Hospital Clinical Research Centre, Kingston, Ontario, Canada matesm@kgh.kari.net.
Abstract
PURPOSE: Curative chemotherapy for breast cancer is associated with significant toxicities including emergency room (ER) visits and hospital admissions (HAs), events that are underreported in clinical trials. This study examined the reasons for, and factors associated with, ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. PATIENTS AND METHODS: A retrospective study of all patients who completed at least one cycle of curative chemotherapy for breast cancer in 2011 and 2012 was conducted. We recorded ER visits and HAs within 30 days of any chemotherapy. We collected demographics, comorbidities, surgical data, tumor characteristics, chemotherapy type and cycles, and use of granulocyte colony-stimulating factors (G-CSF). RESULTS: A total of 149 patients underwent curative chemotherapy. Mean age was 58.6 years. Adjuvant chemotherapy was received by 85% of patients and G-CSF by 88.6%. At least one ER visit occurred in 53% of patients, and 13% required HA. The most common causes of ER visits were fever without neutropenia (23.3%), pain (12.8%), and febrile neutropenia (9%). Stage of breast cancer was the only factor statistically significantly associated with ER visits (P = .045); tumor size (P = .019), adjuvant chemotherapy (P = .045), and lower number of chemotherapy cycles (P = .005) were significantly associated with HA. CONCLUSION: Future research should focus on identifying the patient, provider, and health system factors associated with ER visits and HAs after chemotherapy for breast cancer, to minimize them and lessen the burden on the health care system.
PURPOSE: Curative chemotherapy for breast cancer is associated with significant toxicities including emergency room (ER) visits and hospital admissions (HAs), events that are underreported in clinical trials. This study examined the reasons for, and factors associated with, ER visits and HA after curative chemotherapy for breast cancer in a tertiary Ontario hospital. PATIENTS AND METHODS: A retrospective study of all patients who completed at least one cycle of curative chemotherapy for breast cancer in 2011 and 2012 was conducted. We recorded ER visits and HAs within 30 days of any chemotherapy. We collected demographics, comorbidities, surgical data, tumor characteristics, chemotherapy type and cycles, and use of granulocyte colony-stimulating factors (G-CSF). RESULTS: A total of 149 patients underwent curative chemotherapy. Mean age was 58.6 years. Adjuvant chemotherapy was received by 85% of patients and G-CSF by 88.6%. At least one ER visit occurred in 53% of patients, and 13% required HA. The most common causes of ER visits were fever without neutropenia (23.3%), pain (12.8%), and febrile neutropenia (9%). Stage of breast cancer was the only factor statistically significantly associated with ER visits (P = .045); tumor size (P = .019), adjuvant chemotherapy (P = .045), and lower number of chemotherapy cycles (P = .005) were significantly associated with HA. CONCLUSION: Future research should focus on identifying the patient, provider, and health system factors associated with ER visits and HAs after chemotherapy for breast cancer, to minimize them and lessen the burden on the health care system.
Authors: M Powis; P Groome; N Biswanger; C Kendell; K M Decker; E Grunfeld; M L McBride; R Urquhart; M Winget; G A Porter; M K Krzyzanowska Journal: Curr Oncol Date: 2019-10-01 Impact factor: 3.677
Authors: Vikram Jairam; Victor Lee; Henry S Park; Charles R Thomas; Edward R Melnick; Cary P Gross; Carolyn J Presley; Kerin B Adelson; James B Yu Journal: JAMA Oncol Date: 2019-07-01 Impact factor: 31.777
Authors: Carme Miret; Laia Domingo; Javier Louro; Teresa Barata; Marisa Baré; Joana Ferrer; Maria Carmen Carmona-García; Xavier Castells; Maria Sala Journal: BMC Health Serv Res Date: 2019-12-05 Impact factor: 2.655
Authors: Monika K Krzyzanowska; Jim A Julian; Chu-Shu Gu; Melanie Powis; Qing Li; Katherine Enright; Doris Howell; Craig C Earle; Sonal Gandhi; Sara Rask; Christine Brezden-Masley; Susan Dent; Leena Hajra; Orit Freeman; Silvana Spadafora; Caroline Hamm; Nadia Califaretti; Maureen Trudeau; Mark N Levine; Eitan Amir; Louise Bordeleau; James A Chiarotto; Christine Elser; Juhi Husain; Nicole Laferriere; Yasmin Rahim; Andrew G Robinson; Ted Vandenberg; Eva Grunfeld Journal: BMJ Date: 2021-12-08