Risk Factors for Emergency Room and Hospital Care Among Patients With Solid Tumors on Immune Checkpoint Inhibitor Therapy.

Autor:	Parikh AB; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH.; Tisch Cancer Institute, Division of Hematology/Oncology., Zhong X; Division of Biostatistics., Mellgard G; Icahn School of Medicine at Mount Sinai, New York., Qin Q; Tisch Cancer Institute, Division of Hematology/Oncology., Patel VG; Tisch Cancer Institute, Division of Hematology/Oncology., Wang B; Tisch Cancer Institute, Division of Hematology/Oncology., Alerasool P; Tisch Cancer Institute, Division of Hematology/Oncology.; New York Medical College, Valhalla, NY., Garcia P; Icahn School of Medicine at Mount Sinai, New York., Leiter A; Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai., Gallagher EJ; Tisch Cancer Institute, Division of Hematology/Oncology.; Division of Endocrinology, Diabetes, and Bone Disease, Icahn School of Medicine at Mount Sinai., Clinton S; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Mortazavi A; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Monk P; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Folefac E; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Yin M; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Yang Y; Genitourinary Oncology Section, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center-James Cancer Hospital, Columbus, OH., Galsky M; Tisch Cancer Institute, Division of Hematology/Oncology., Oh WK; Tisch Cancer Institute, Division of Hematology/Oncology., Tsao CK; Tisch Cancer Institute, Division of Hematology/Oncology.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2021 Mar 01; Vol. 44 (3), pp. 114-120.
DOI:	10.1097/COC.0000000000000793
Abstrakt:	Objectives: Immune checkpoint inhibitors (ICIs) are being increasingly used across cancer types. Emergency room (ER) and inpatient (IP) care, common in patients with cancer, remain poorly defined in this specific population, and risk factors for such care are unknown. Methods: We retrospectively reviewed charts for patients with solid tumors who received >1 ICI dose at 1 of 2 sites from January 1, 2011 to April 28, 2017. Demographics, medical history, cancer diagnosis/therapy/toxicity details, and outcomes were recorded. Descriptive data detailing ER/IP care at the 2 associated hospitals during ICI therapy (from first dose to 3 mo after last dose) were collected. The Fisher exact test and multivariate regression analysis was used to study differences between patients with versus without ER/IP care during ICI treatment. Results: Among 345 patients studied, 50% had at least 1 ER visit during ICI treatment and 43% had at least 1 IP admission. Six percent of ER/IP visits eventually required intensive care. A total of 12% of ER/IP visits were associated with suspected or confirmed immune-related adverse events. Predictors of ER care were African-American race (odds ratio [OR]: 3.83, P=0.001), Hispanic ethnicity (OR: 3.12, P=0.007), and coronary artery disease (OR: 2.43, P=0.006). Predictors of IP care were African-American race (OR: 2.38, P=0.024), Hispanic ethnicity (OR: 2.29, P=0.045), chronic kidney disease (OR: 3.89, P=0.006), angiotensin converting enzyme inhibitor/angiotensin receptor blocker medication use (OR: 0.44, P=0.009), and liver metastasis (OR: 2.32, P=0.003). Conclusions: Understanding demographic and clinical risk factors for ER/IP care among patients on ICIs can help highlight disparities, prospectively identify high-risk patients, and inform preventive programs aimed at reducing such care. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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