Predictors of Suboptimal Follow-up in Pediatric Cancer Survivors
| Autor: | David D. Schwartz, Sule Unal, Lynnette L. Harris, Julienne Brackett, Hilary S. Suzawa, M. Fatih Okcu, Gulsah Tanyildiz, Kala Y. Kamdar, Leana May, Rosalind Bryant, Ernest Frugé, Suzanne Elizabeth Holm, Larry Laufman, ZoAnn E. Dreyer |
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| Rok vydání: | 2016 |
| Předmět: |
Pediatrics
medicine.medical_specialty Adolescent Aftercare Logistic regression 03 medical and health sciences 0302 clinical medicine Risk Factors Survivorship curve Neoplasms Medicine Humans 030212 general & internal medicine Survivors Child Socioeconomic status business.industry Attendance Infant Newborn Infant Hematology Odds ratio Patient Acceptance of Health Care Pediatric cancer Confidence interval Transplantation Oncology 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Multivariate Analysis Patient Compliance business |
| Zdroj: | Journal of pediatric hematology/oncology. 39(3) |
| ISSN: | 1536-3678 |
| Popis: | Attendance to follow-up care after completion of cancer treatment is an understudied area. We examined demographic, clinical, and socioeconomic predictors of follow-up by pediatric cancer patients at a large center in 442 newly diagnosed patients using multivariable logistic regression analyses. Patients who did not return to clinic for at least 1000 days were considered lost to follow-up. Two hundred forty-two (54.8%) patients were lost. In multivariable analyses, the following variables were independent predictors of being lost to follow-up: treatment with surgery alone (odds ratio [OR]=6.7; 95% confidence interval [CI], 3.1-14.9), older age at diagnosis (reference, 0 to 4; ages, 5 to 9: OR=1.8, 95% CI, 1.1-3; ages, 10 to 14: OR=3.3; CI, 1.8-6.1; and ages, 15 and above: OR=4.8; CI, 2.1-11.7), lack of history of stem cell transplantation (OR=2, 95% CI, 1.04-3.7) and lack of insurance (OR=3.4; CI, 1.2-9.2). Hispanic patients had the best follow-up rates (53.7%) compared to whites and blacks (P=0.03). Attendance to long-term follow-up care is suboptimal in childhood cancer survivors. Predictors that were associated with nonattendance can be used to design targeted interventions to improve follow-up care for survivors of pediatric cancer. |
| Databáze: | OpenAIRE |
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