Nationwide trends in in-patient chemotherapy hospitalizations, cost, and mortality for patients with testicular carcinoma.

Authors

null

Saqib Abbasi

Kansas University Cancer Center, Westwood, KS

Saqib Abbasi , Elizabeth Marie Wulff-Burchfield , Rahul Atul Parikh

Organizations

Kansas University Cancer Center, Westwood, KS, University of Kansas Medical Center, Westwood, KS

Research Funding

No funding received
None

Background: Salvage therapy for advanced Testicular Carcinoma involves patients receiving ifosfamide are treated in hospital for risk of neuro-toxicities. We evaluated annual trends to assess the health care burden of testicular patients admitted for chemotherapy, as well as co-morbidities and complications associated with mortality. Methods: The National Inpatient Sample is a nationwide sample of all US hospital discharges. We collected data from the years of 2002 to 2017 on patients with Testicular Carcinoma who were receiving chemotherapy, to capture patients recieving ifosfamide and cisplatin in an in-patient setting. Patients undergoing an autologous stem cell transplant were excluded. Annual trends for inpatient mortality, length of stay, and total costs of admission were assessed. A univariate logistic regression analysis was used to calculate odds ratios (OR) for the effect of comorbid conditions and acute inpatient complications on in-patient mortality. Results: Hospitalizations for ifosfamide and cisplatin based treatment among patients with Testicular Carcinoma remained stable from a weighted national estimate of 2,261 in 2002 to 2,160 in 2017. Length of stay increased from 4.6 days to 5.5 days (p=0.01). Cost of stay increased from $26,140 to $53,193 (p <0.001) when adjusted for inflation. The average age of patients was 32.6 years. In-patient mortality was low at 0.2% in 2002 to <0.1% in 2017. Among comorbid conditions, heart failure was associated with increased mortality (OR 21.9). Among acute complications – acute kidney injury (OR 32.6), infection (OR 15.3), neurotoxicity (OR 12.3) were associated with significantly higher mortality. Conclusions: The increase in cost of stay is out of proportion to increases in length of stay. Indicating a disproportionate increase in financial toxicity for these patients. Patients with underlying heart disease are at increased risk of complications. Care needs to be taken to specifically identify patients at risk for renal failure and infectious complications.

Co-morbid condition/in-patient complication and association with in-patient mortality.

Co-morbid Condition/Complication
Odds Ratio
95% Wald
P-value
Confidence
Limits
Age > 40
1.95
0.71
5.38
0.1956
Heart Failure
21.93
2.78
173.26
0.0034
Atrial Fibrillation
4
0.36
45.14
0.2621
Hypertension
0.24
0.03
2.03
0.1917
Acute Renal Failure
32.63
12.01
88.65
<.0001
Infection
15.28
4.87
47.9
<.0001
Neurotoxicity
12.34
1.59
95.72
0.0162
Venous Thromboembolism
2.35
0.53
10.37
0.2595

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Genitourinary Cancer—Prostate, Testicular, and Penile

Track

Genitourinary Cancer—Prostate, Testicular, and Penile

Sub Track

Germ Cell/Testicular Cancer

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr e17012)

DOI

10.1200/JCO.2021.39.15_suppl.e17012

Abstract #

e17012

Abstract Disclosures

Similar Abstracts

First Author: Arun Kumar

Abstract

2023 ASCO Annual Meeting

Analysis of hospitalizations of patients with penile cancer: A national population-based study.

First Author: Philip Onyekaoso Kanemo

Abstract

2023 ASCO Quality Care Symposium

Safe and reliable inpatient chemotherapy administration: Impact of an ambulatory oncology pharmacist.

First Author: Mary Yousef