Hospital challenges faced by frail patients with ovarian cancer and the adverse outcomes: A nationwide study.

Authors

null

Nataly Ortega Yaguachi

State University of New York, Upstate Medical University, Syracuse, NY

Nataly Ortega Yaguachi , Saad Javaid , Kelly Frasier , Vivian Li , Julia Vinagolu-Baur , Evadne Rodriguez , Olivia Del Castillo , Raquel Batista , Kenlee Jonas , Laura Palma

Organizations

State University of New York, Upstate Medical University, Syracuse, NY, Wyckoff Heights Medical Center, Brooklyn, NY, Nuvance Health/Vassar Brothers Medical Center, Poughkeepsie, NY, Lake Erie College of Osteopathic Medicine, Erie, PA, University of Missouri-Columbia, School of Medicine, Columbia, MO, Dutchess Community College, Beacon, NY

Research Funding

No funding sources reported

Background: Ovarian cancer is a leading cause of gynecological cancer-related deaths and one of the most common causes of cancer-related fatalities among women. Frailty has been identified as a predictor of unfavorable outcomes for cancer patients, but there is limited research on its impact on individuals with ovarian cancer. We examined the effects of Frailty in hospitalized ovarian cancer patients and the associated outcomes. Methods: National Inpatient Sample (NIS) 2020 was used to identify the patients with a primary diagnosis of ovarian cancer (local/regional and advanced metastatic) and was stratified into patients with and without Frailty. The primary outcome was mortality, and secondary outcomes included length of stay, the total cost of hospitalization, and other in-hospital adverse outcomes. Multivariate logistic regression analysis was used to calculate the outcomes after adjusting for confounding variables. Results: A total of 19790 patients were hospitalized with a primary diagnosis of Ovarian cancer, among which 3215 (16.24%) patients had the concurrent diagnosis of Frailty. The mean age of patients with and without Frailty was 65.76 (+/-13.10) and 60 (+/-14.45),p<0.001, respectively. After adjusting for confounding variables, Frailty was associated with an increased risk of mortality in patients with ovarian cancer (OR=3.01(1.83-4.95); p<0.001). Patients with Frailty were also at risk of increased length of stay (+3.80 Days (3.09-4.50; p<0.001) and total cost of hospitalization (+ $ 34662 (22973-46351); p<0.001). Frail patients also had an increased likelihood of Acute respiratory failure (OR=1.72 (1.22-2.42); p=0.002), Acute kidney injury (OR=2.40 (1.88-3.05); p<0.001), Sepsis (OR=4.97 (3.19-7.75); p<0.001), ICU admission (OR=2.23 (1.44-3.45); p<0.001), Pneumonia (OR=2.63 (1.69-4.10); p<0.001), total parenteral nutrition (OR=14.20 (7.80-25.83); p<0.001) and Intubation (OR=2.11 (1.21-3.69); p=0.008). However, there was no difference in the risk of noninvasive mechanical ventilation (OR=2.07 (0.95-4.52); p=0.48) or enteral feeding (OR=32.73 (0.63-1696); p=0.08). Conclusions: Frailty in ovarian cancer patients is considered an independent predictor of mortality. It is also associated with increased healthcare resource utilization and adverse in-hospital outcomes.

Diligent management of frailty is essential to improve overall outcomes and reduce the risk of complications in patients with ovarian cancer.

Ovarian cancer with and without Frailty
Length of stay+3.80 Days (3.09-4.50) p<0.001
Total Charges+ $ 34662 (22973-46351) p<0.001
OR (95% CI),p-value
Acute respiratory failure1.72(1.22-2.42) p=0.002
ICU2.23(1.44-3.45) p<0.001
Sepsis4.97(3.19-7.75) p<0.001
Total parenteral nutrition14.20(7.80-25.83) p<0.001
Acute kidney injury2.40(1.88-3.05) p<0.001
Intubation2.11(1.21-3.69) p=0.008

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Abstract Details

Meeting

2024 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Gynecologic Cancer

Track

Gynecologic Cancer

Sub Track

Ovarian Cancer

Citation

J Clin Oncol 42, 2024 (suppl 16; abstr 5572)

DOI

10.1200/JCO.2024.42.16_suppl.5572

Abstract #

5572

Poster Bd #

443

Abstract Disclosures

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