Health resource utilisation by patients with neuroendocrine tumours with or without carcinoid heart disease: a multinational study.

Autor:	Tanaka H; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo 01509-900, Brazil., Uema D; Division of Health Care Sciences Center for Clinical Research and Management Education Dresden., Rego JFM; Hospital Universitário Onofre Lopes, Natal 59012-300, Brazil., Weschenfelder RF; Hospital Moinhos de Vento, Porto Alegre 90035-001, Brazil., D'Agustini N; Hospital Moinhos de Vento, Porto Alegre 90035-001, Brazil., Filho DRR; Hospital Universitário Walter Cantídio, Fortaleza 60420-570, Brazil., O'Connor JM; Hospital de Gastroenterología Bonorino Udaondo, C1264AAA Buenos Aires, Argentina., Luca R; Hospital de Gastroenterología Bonorino Udaondo, C1264AAA Buenos Aires, Argentina., Nuñez JER; Instituto do Câncer do Estado de São Paulo, São Paulo, Brazil., de Barros E Silva MJ; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo 01509-900, Brazil., Riechelmann RP; Department of Clinical Oncology, AC Camargo Cancer Center, São Paulo 01509-900, Brazil.
Jazyk:	angličtina
Zdroj:	Ecancermedicalscience [Ecancermedicalscience] 2020 Nov 13; Vol. 14, pp. 1141. Date of Electronic Publication: 2020 Nov 13 (Print Publication: 2020).
DOI:	10.3332/ecancer.2020.1141
Abstrakt:	Background: Carcinoid heart disease (CHD) is a rare and severe complication from carcinoid syndrome which may be associated with high health resource utilisation (HRU). We aimed to compare HRU between patients with and without CHD. Methods: Multicentre retrospective study of 137 consecutive patients with neuroendocrine tumours (NET) and elevated urinary 5-hydroxyindoleacetic acid treated in seven large hospitals in Latin America. We used the chi-squared test for binary variables and the Mann-Whitney test for quantitative correlations. Variables were entered into a multivariable linear regression model for higher HRU. Results: One-third of the patients had (45) had CHD. Patients with CHD had significantly more emergency visits and echocardiograms as compared to patients without CHD. In the bivariate models, CHD (R 2 = 0.61, p = 0.01), private health system ( R 2 = 0.63, p = 0.02) and simultaneous cardiovascular comorbidities ( R 2 = 0.61, p = 0.04) were associated with a higher HRU. The multivariate model pointed out the accumulated effect of variables on HRU ( R 2 = 0.2, p < 0.01). Conclusions: NET patients with CHD present higher HRU independently of other clinical factors or health system. Effectively treating carcinoid syndrome, and likely delaying the onset of CHD, may potentially reduce the amount of HRU by these patients. Competing Interests: Rachel Riechelmann has received honoraria and consultancy fees from Novartis and Ipsen. The other authors declare that they have no conflict of interest related to the publication of this manuscript. (© the authors; licensee ecancermedicalscience.)
Databáze:	MEDLINE
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