Comorbiditites Contribute To Unplanned Hospitalizations Among GI Cancer Patients

MedicalResearch.com Interview with:
Joanna-Grace M. Manzano, MD

Assistant Professor
Department of General Internal Medicine

Maria E. Suarez-Almazor, MD, PhD
Barnts Family Distinguished Professor
Chief, Section of Rheumatology &
Deputy Chair, Dept. of General  Internal Medicine
UT MD Anderson Cancer Center Houston, TX

Medical Research: What are the main findings of the study?

Response: Our study established that unplanned hospitalization among elderly patients with GI cancer are very common – 93 events per 100-person years.

Certain characteristics were found to have an increased risk for an unplanned hospitalization in our cohort, namely: older age, black race, advanced disease, higher comorbidity score, residing in poor neighborhoods and dual eligibility for Medicare and Medicaid. Esophageal and gastric cancer had the highest risk for unplanned hospitalization among all GI cancer types.

Some of the observed reasons for unplanned hospitalization were potentially preventable and related to the patient’s comorbid illness.

Medical Research: What was most surprising about the results?

Response: We found the high rate of unplanned hospitalizations very surprising. We anticipated that unplanned hospitalizations would be common in our cohort, but 93 events per 100 person-years is a striking number.

Medical Research: What should clinicians and patients take away from your report?

Response: Patients, caregivers and treating physicians (oncologists, primary care physicians and other treating specialists) should recognize that elderly patients who have GI cancer are vulnerable to unplanned hospitalizations.

A high comorbidity score is associated with the highest risk for unplanned hospitalization in our cohort,  and some of the top reasons for unplanned hospitalization are potentially preventable. This should promote efforts at improving coordination of care among all health care providers involved in a cancer patient’s care.  Patients would likely benefit from continued close follow-up with primary care physicians and other treating specialists during the initial years after cancer diagnosis.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Future research should explore if the same patterns we have observed in our cohort hold true among elderly patients with GI cancer outside of Texas.

It would be interesting to find out also if regular follow-up with both oncologists and non-cancer providers during the first years after cancer diagnosis can modify the risk for unplanned hospitalization among patients with high comorbidity scores.

Citation:

Patterns and Predictors of Unplanned Hospitalization in a Population-Based Cohort of Elderly Patients with GI Cancer
Joanna-Grace M. Manzano, Ruili Luo, Linda S. Elting, Marina George, and Maria E. Suarez-Almazor

JCO.2014.55.3131; published online on October 6, 2014;