Evaluation of early unplanned readmissions and predisposing factors in an oncology clinic
Autor: | Zafer Arik, Omer Dizdar, Berkay Yesilyurt, Oktay Halit Aktepe, Gurkan Guner, Alev Turker, Deniz Can Guven, Basak Sayinalp, Ibrahim Yahya Cakir, Furkan Ceylan, Hasan Cagri Yildirim, Engin Cesmeci |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Multivariate analysis Oncology clinic Aftercare Disease Ambulatory Care Facilities Patient Readmission 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Neoplasms Medicine Outpatient clinic Humans 030212 general & internal medicine Hypoalbuminemia Aged Retrospective Studies Polypharmacy Aged 80 and over business.industry Cancer Emergency department Middle Aged medicine.disease Patient Discharge Causality Hospitalization Oncology 030220 oncology & carcinogenesis business Emergency Service Hospital |
Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 29(7) |
ISSN: | 1433-7339 |
Popis: | Unplanned readmission in the first 30 days after discharge is an important medical problem, although the data on cancer patients is limited. So we planned to evaluate the rates and causes of early readmissions and the predisposing factors. Patients hospitalized in Hacettepe University Oncology services between August 2018 and July 2019 were included. The demographic features, tumor stages, regular drugs, last laboratory parameters before discharge, and readmissions in the first 30 days after discharge were recorded. The predisposing features were evaluated with univariate and multivariate analyses. A total of 562 hospitalizations were included. The mean age of the patients was 58.5 ± 14.5 years. Almost 2/3 of the hospitalizations were due to symptom palliation and infections. Eighty-three percent of the patients had advanced disease, and over 60% had an ECOG score of 2 and above. In the first 30 days after discharge, 127 patients were readmitted (22.6%). Advanced stage disease, presence of polypharmacy (5 or more regular drugs), hospitalization setting (emergency department (ED) vs. outpatient clinic), and hypoalbuminemia (< 3 gr/dL) were associated with a statistically significant increase in the risk of readmission. Among these factors, advanced-stage disease (HR: 2.847, 95% CI: 1.375–5.895), hospitalization from ED (HR: 1.832, 95% CI: 1.208–2.777), and polypharmacy (HR: 1.782, 95% CI: 1.173–2.706) remained significant in multivariate analyses. In this study, 22% of cancer patients had early readmissions. The readmission risk increased in patients with advanced disease, hospitalization from ED, and polypharmacy. The optimal post-discharge plan may reduce readmissions in all oncology patients, with priority for these patient groups. |
Databáze: | OpenAIRE |
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