scholarly journals Comparison of Cancer Patients to Non-Cancer Patients among COVID-19 Inpatients at a National Level

Cancers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1436
Author(s):  
Alain Bernard ◽  
Jonathan Cottenet ◽  
Philippe Bonniaud ◽  
Lionel Piroth ◽  
Patrick Arveux ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Mortality Risk ◽  
Hospital Admissions ◽  
National Level ◽  
Administrative Database ◽  
Hospital Death ◽  
Solid Cancer ◽  
Hematological Cancer ◽  
Risk Of Death

(1) Background: Several smaller studies have shown that COVID-19 patients with cancer are at a significantly higher risk of death. Our objective was to compare patients hospitalized for COVID-19 with cancer to those without cancer using national data and to study the effect of cancer on the risk of hospital death and intensive care unit (ICU) admission. (2) Methods: All patients hospitalized in France for COVID-19 in March–April 2020 were included from the French national administrative database, which contains discharge summaries for all hospital admissions in France. Cancer patients were identified within this population. The effect of cancer was estimated with logistic regression, adjusting for age, sex and comorbidities. (3) Results: Among the 89,530 COVID-19 patients, we identified 6201 cancer patients (6.9%). These patients were older and were more likely to be men and to have complications (acute respiratory and kidney failure, venous thrombosis, atrial fibrillation) than those without cancer. In patients with hematological cancer, admission to ICU was significantly more frequent (24.8%) than patients without cancer (16.4%) (p < 0.01). Solid cancer patients without metastasis had a significantly higher mortality risk than patients without cancer (aOR = 1.4 [1.3–1.5]), and the difference was even more marked for metastatic solid cancer patients (aOR = 3.6 [3.2–4.0]). Compared to patients with colorectal cancer, patients with lung cancer, digestive cancer (excluding colorectal cancer) and hematological cancer had a higher mortality risk (aOR = 2.0 [1.6–2.6], 1.6 [1.3–2.1] and 1.4 [1.1–1.8], respectively). (4) Conclusions: This study shows that, in France, patients with COVID-19 and cancer have a two-fold risk of death when compared to COVID-19 patients without cancer. We suggest the need to reorganize facilities to prevent the contamination of patients being treated for cancer, similar to what is already being done in some countries.

The Prevalence of Frailty in Cancer Patients and Mortality Prediction With a Novel Frailty Index Based Clinical Algorithm-A Multicenter, Prospective, Observational Study

2020 ◽  
Author(s):  
Xi Jin ◽  
Yue Ren ◽  
Li Shao ◽  
Zengqing Guo ◽  
Chang Wang ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Frailty Index ◽  
National Level ◽  
Laboratory Data ◽  
Mortality Prediction ◽  
Prediction Algorithm ◽  
Tumor Type ◽  
Risk Of Death ◽  
Increased Risk ◽  
Chinese Cancer Patients

Abstract Purpose To investigate the prediction capacity and status of frailty in Chinese cancer patients in national level, through establishing a novel prediction algorithm. Methods The percentage of frailty in different ages, provinces and tumor type groups of Chinese cancer patients were revealed. The predictioncapacity of frailty on mortality of Chinese cancer patients was analyzed by FI-LAB that is composed of routine laboratory data from accessible blood test and calculated as the ratio of abnormal factors in 22 variables. Establishment of a novel algorithm MCP(mortality of cancer patients)to predict the five-year mortality in Chinese cancer patients was accomplished and its prediction capacity was tested in the training and validation sets using ROC analysis. ResultsWe found that the increased risk of death in cancer patients can be successfully identified through FI-LAB. The univariable and multivariable Cox regression were used to evaluate the effect of frailty on death. In the 5-year follow-up, 20.6% of the 2959 participants (age = 55.8 ± 11.7 years; 43.5% female) were dead while the mean FI-LAB score in baseline was 0.23 (standard deviation = 0.13; range = 0 to 0.73).Frailty (after adjusting for gender, age, and other confounders) could be directly correlated with increased risk of death, with a hazard ratio of 12.67 (95% confidence interval CI: 7.19, 22.31) in comparison with those without frailty. In addition, MCP algorithm presented an area under the ROC (AUC) of 0.691 (95% CI: 0.659-0.684) and 0.648 (95% CI: 0.613-0.684) in the training and validation set, respectively. Conclusion Frailty is common in cancer patients and FI-LAB has high prediction capacity on mortality. The MCP algorithm is a good supplement for frailty evaluation and mortality prediction in cancer patients.

scholarly journals Mortality risk from acute aortic dissection among hospital admissions during weekends and holiday season

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0255942
Author(s):  
I-Min Su ◽  
Huei-Kai Huang ◽  
Peter Pin-Sung Liu ◽  
Jin-Yi Hsu ◽  
Shu-Man Lin ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Aortic Dissection ◽  
Mortality Risk ◽  
Acute Aortic Dissection ◽  
Hospital Admissions ◽  
Weekend Effect ◽  
Hospital Death ◽  
Research Database ◽  
Risk Of Mortality ◽  
Holiday Season

Background Acute aortic dissection is a life-threatening condition associated with high mortality rate. Findings from previous studies addressing the “weekend effect” on the mortality rate from an acute aortic dissection mortality have been inconsistent. Furthermore, the effect of admission for acute aortic dissection during the holiday season has not been previously investigated. Objective Our aim was to evaluate the effect of admission for acute aortic dissection during holiday season or weekends on the risk of mortality. Methods We conducted a retrospective analysis of nationwide cohort data from the Taiwan’s National Health Insurance Research Database. We collected data on all adult patients hospitalized for acute aortic dissection between 2001 and 2017 in Taiwan and classified them into the following three groups based on day of admission: holiday season (at least 4 consecutive days; n = 280), weekend (n = 1 041), and weekday (n = 3 109). The following three outcomes were evaluated: in-hospital mortality, 7-day mortality, and 180-day mortality. Results A multivariable logistic regression was used to adjust for possible cofounders on the measured outcomes. Compared to weekday admissions for acute aortic dissection, weekend admissions resulted in a 29% increase in the risk of in-hospital death (aOR = 1.29; 95% CI, 1.05–1.59; P = 0.0153), with a 25% increase in the 7-day (aOR = 1.25; 95% CI, 1.001–1.563; P = 0.0492) and 20% increase in the 180-day mortality risk (aOR = 1.20; 95% CI, 1.01–1.42; P = 0.0395). Of note, admission over the holiday season did not result in a higher mortality risk than for weekday admissions; this finding, however, might reflect insufficient statistical power on subgroup analysis. Conclusion Patients admitted for acute aortic dissection during the weekends are at higher risk of mortality compared to those admitted on weekdays. Our finding likely reflects inadequate staffing and team experience of weekend staff and can guide healthcare policy makers to improve patient outcomes.

The impact of guideline treatment nonadherence on survival for colorectal cancer patients: Propensity score calibration via a validation cohort.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 308-308
Author(s):  
Robert Brooks Hines ◽  
Sue Min Lai ◽  
Joaquina Celebre Baranda ◽  
Kimberly K. Engelman ◽  
Frank Dong ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Propensity Score ◽  
Cancer Patients ◽  
Validation Cohort ◽  
Treatment Guidelines ◽  
Risk Of Death ◽  
Increased Risk ◽  
The Impact

308 Background: The quality of cancer care has been the focus of ongoing concern for cancer researchers, providers, and policy makers. The objectives of this study were: 1) to evaluate nonadherence with National Comprehensive Cancer Network treatment guidelines for colorectal cancer (CRC) patients and the impact on survival, and 2) to obtain error-corrected estimates of effect by means of propensity score calibration via a validation cohort. Methods: CRC patients identified by the Georgia Comprehensive Cancer Registry for the years 2000-07 were eligible (N = 18,388). Naïve propensity score (PSn) adjustment and PS calibration (PSC) via a validation cohort were utilized to obtain hazard ratio estimates for the impact of guideline treatment nonadherence on 5-year overall survival. The validation cohort contained additional information on comorbidity and payer status which was used to obtain error-corrected estimates of effect by PSC. Results: Treatment nonadherence conferred a large increased risk of death early in the follow-up period which declined over time (Table 1). Comparison of results from the PSn and PSC models indicated moderate to large bias due to unmeasured confounding in the PSn model (data not shown). Conclusions: PSC produced attenuated estimates and had an impact on study conclusions in the latter follow-up period. For CRC patients, health services research into the quality of care received by cancer patients is necessary to continue the improving trend in CRC-related mortality. [Table: see text]

Expression of a CD44 variant containing exons 8 to 10 is a useful independent factor for the prediction of prognosis in colorectal cancer patients.

1996 ◽  
Vol 14 (4) ◽  
pp. 1122-1127 ◽  
Author(s):  
A Yamaguchi ◽  
T Urano ◽  
T Goi ◽  
M Saito ◽  
K Takeuchi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Cox Regression ◽  
Prognostic Significance ◽  
Hematogenous Metastasis ◽  
High Recurrence Rate ◽  
Positive Staining ◽  
Cd44 Variant ◽  
Risk Of Death ◽  
Colorectal Cancer Patients

PURPOSE To determine the expression of the CD44 variant containing a variant exon 8 to 10 product (CD44v8-10) in colorectal cancer and to evaluate its prognostic value. MATERIALS AND METHODS CD44v8-10 was studied in resected tumors and normal mucosae obtained from 215 colorectal cancer patients (118 colon cancer and 97 rectal cancer). The expression of CD44v8-10 was analyzed immunohistochemically using the anti-CD44v8-10 monoclonal antibody (mAb) 44-1V. RESULTS One hundred of 215 cancer tissues expressed CD44v8-10. Positive staining was intense mainly on the cell membranes. There was no significant correlation between expression of CD44v8-10 and histologic type, primary tumor, lymphatic invasion, venous invasion, or peritoneal invasion. There were significant correlations between CD44v8-10 immunoreactivity and both lymph node and hematogenous metastasis. Patients with CD44v8-10-positive tumors had a greater relative risk of death compared with those whose tumors were CD44v8-10-negative. Among 169 patients who underwent curative resection, CD44v8-10 expression correlated with a high recurrence rate. The 5- and 10-year survival rates were 90.3% of patients with CD44v8-10-negative tumors, and 72.1% and 58.0% of those with CD44v8-10-positive tumors, respectively; these differences between the two groups of patients were significant (P < .01). In multivariate analysis using the Cox regression model, CD44v8-10 expression emerged as an independent prognostic indicator. CONCLUSION The results suggest that CD44v8-10 plays a role in metastasis of colorectal cancer, and tha CD44v8-10 expression may be a biologic marker of prognostic significance.

scholarly journals Effectiveness of screening colonoscopy in reducing the risk of death from right and left colon cancer: a large community-based study

Gut ◽  
2016 ◽  
Vol 67 (2) ◽  
pp. 291-298 ◽  
Author(s):  
Chyke A Doubeni ◽  
Douglas A Corley ◽  
Virginia P Quinn ◽  
Christopher D Jensen ◽  
Ann G Zauber ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Mortality Risk ◽  
Left Colon ◽  
Screening Colonoscopy ◽  
Cancer Death ◽  
Right Colon ◽  
Community Based ◽  
Risk Of Death ◽  
Colon Cancers ◽  
Rectal Cancers

ObjectiveScreening colonoscopy's effectiveness in reducing colorectal cancer mortality risk in community populations is unclear, particularly for right-colon cancers, leading to recommendations against its use for screening in some countries. This study aimed to determine whether, among average-risk people, receipt of screening colonoscopy reduces the risk of dying from both right-colon and left-colon/rectal cancers.DesignWe conducted a nested case–control study with incidence-density matching in screening-eligible Kaiser Permanente members. Patients who were 55–90 years old on their colorectal cancer death date during 2006–2012 were matched on diagnosis (reference) date to controls on age, sex, health plan enrolment duration and geographical region. We excluded patients at increased colorectal cancer risk, or with prior colorectal cancer diagnosis or colectomy. The association between screening colonoscopy receipt in the 10-year period before the reference date and colorectal cancer death risk was evaluated while accounting for other screening exposures.ResultsWe analysed 1747 patients who died from colorectal cancer and 3460 colorectal cancer-free controls. Compared with no endoscopic screening, receipt of a screening colonoscopy was associated with a 67% reduction in the risk of death from any colorectal cancer (adjusted OR (aOR)=0.33, 95% CI 0.21 to 0.52). By cancer location, screening colonoscopy was associated with a 65% reduction in risk of death for right-colon cancers (aOR=0.35, CI 0.18 to 0.65) and a 75% reduction for left-colon/rectal cancers (aOR=0.25, CI 0.12 to 0.53).ConclusionsScreening colonoscopy was associated with a substantial and comparably decreased mortality risk for both right-sided and left-sided cancers within a large community-based population.

scholarly journals Quantitative Analysis of SARS-CoV-2 Antibody Status between Patients with Cancer and Healthy Individuals with Extended Vaccination Dosing Intervals in Canada

2021 ◽  
Vol 29 (1) ◽  
pp. 68-76
Author(s):  
Andrew Robinson ◽  
Andrew Mazurek ◽  
Minqi Xu ◽  
Yanping Gong
Keyword(s):  
Cancer Patients ◽  
Hematological Malignancies ◽  
Cross Sectional Study ◽  
Cytotoxic Chemotherapy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Solid Cancer ◽  
Cross Sectional ◽  
Hematological Cancer ◽  
Antibody Levels

(1) Background: To date, data addressing the antibody response of cancer patients to SARS-CoV-2 vaccines are limited. To our knowledge, this is the first report to evaluate humoral immunity. responses in Canadian cancer patients. (2) Methods: 116 cancer patients and 35 healthy participants were enrolled in this cross-sectional study. The interval between the first and second doses were closely matched during analysis. IgG antibodies against the SARS-CoV-2 spike receptor–binding domain were determined using an enzyme-linked immunosorbent assay (ELISA). (3) Results: Following two doses of SARS-CoV-2 vaccine (including BNT162b2, AZD1222, and mRNA-1273), the mean serum anti-spike protein antibody level was 382.4 BAU/mL (binding antibody unit, SD ± 9.4) in the control group, 265.8 BAU/mL (±145.7) in solid cancer patients, and 168.2 BAU/mL (±172.9) in hematological cancer patients. Observed differences were significantly lower in both solid and hematological groups when comparing to the control group (p ≤ 0.0001). In solid cancer group, patients with cytotoxic chemotherapy demonstrated significantly lower antibody levels (p < 0.01), whereas the rest of the patients showed similar antibody levels as the healthy control. Antibody levels were lower in those on treatment than those off treatment in patients with hematological malignancies (p < 0.0001) but not for those with solid cancers (p = 0.4553). (4) Conclusions: After two doses of the SARS-CoV-2 vaccination, patients with solid and hematological malignancies demonstrated impaired serological responses. This was particularly prominent if there was cytotoxic chemotherapy or systemic therapy in solid and hematological cancer, respectively.

scholarly journals Development of a multivariable model predicting COVID-19 mortality risk from comorbidities in an Italian cohort of 18,286 confirmed cases aged 40 years or older

2020 ◽  
Author(s):  
Anita Andreano ◽  
Rossella Murtas ◽  
Sara Tunesi ◽  
Maria Teresa Greco ◽  
David Consolazio ◽  
...  
Keyword(s):  
High Risk ◽  
Mortality Risk ◽  
Chronic Conditions ◽  
External Validation ◽  
Administrative Database ◽  
Multivariable Logistic Regression Model ◽  
Risk Of Death ◽  
And Gender ◽  
High Risk Subject ◽  
Italian Cohort

Abstract Background: large studies on the predictive role of chronic conditions on mortality from COVID‑19 are scarce. We developed a predictive model of death from COVID‑19 in an Italian cohort aged 40 years or older.Methods: we conducted a cohort study on prospectively collected data. The cohort included all (n=18,286) swab positive cases ≥40 year-old in patients registered with the Agency for Health Protection (AHP) of Milan up to 27/04/2020. Data on comorbidities were obtained from the chronic condition administrative database of the AHP. A multivariable logistic regression model, including age and gender and the selected conditions, was fitted to predict 30-day mortality risk and internally validated. External validation and recalibration were performed in a cohort of untested subjects with COVID-19 like symptoms. R software was used for the analysis.Results: chronic conditions having the largest model-adjusted odds ratio (OR) of dying within 30 days from COVID-19 infection were chronic heart failure (OR=1.9, 95%CI 1.5-2.5), tumors (OR=1.8, 95%CI 1.4-2.3), complicated diabetes (OR=1.6, 95%CI 1.1-2.2) and dialysis-dependent chronic kidney disease (OR=1.5, 95%CI 1.0-2.2). Bootstrap-validated c-index was 0.78. The model fitted on the validation cohort had a c-index of 0.93, but required recalibration. With this latter model, at a 10% risk of death threshold, 11% of the AHP population aged 40 years or older is considered at high risk.Conclusion: we identified a selected number of comorbidities predicting early risk of death in a large COVID-19 cohort aged 40 years or older. In a new epidemic wave, our results will help physicians and health systems to identify high-risk subject to target for prevention and therapy in this specific age group.

scholarly journals Sleep problems and their interaction with physical activity and fatigue in hematological cancer patients during onset of high dose chemotherapy

2021 ◽  
Author(s):  
LUCIA CASTELLI ◽  
Thomas Elter ◽  
Florian Wolf ◽  
Matthew Watson ◽  
Alexander Schenk ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Patients ◽  
Mediation Analysis ◽  
Sleep Problems ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Solid Cancer ◽  
German Population ◽  
Hematological Cancer ◽  
Eortc Qlq

Abstract Purpose Sleep problems reported by hematological cancer patients are usually linked to higher levels of cancer-related fatigue. Although the awareness of sleep problems in solid cancer patients is rising, there has been less attention to the issue in hematological cancer patients. The present study assesses the differences in sleep by comparing physical activity and fatigue levels among hematological cancer patients during the onset of chemotherapy. Furthermore, it investigates the relationship between sleep, physical activity, and fatigue through mediation analysis. Methods The recruited sample consists of 58 newly diagnosed hematological cancer patients (47.1 ± 15.4 yrs; 51.7% males). Subjects completed questionnaires assessing sleep (PSQI), physical activity (visual analogue scale), fatigue (MFI-20), anxiety, depression (HADS), and quality of life (EORTC QLQ-C30) within two weeks from starting treatment.Results The sample reported more sleep problems in comparison to the German population norm. The classification as good (ca 25%) or bad sleepers (ca 75%) showed less frequent physical activity (p = .04), higher fatigue (p = .032), anxiety (p = .003), depression (p = .011) and pain (p = .011) in bad sleepers. The mediation analysis revealed significant indirect effects of sleep on fatigue through physical activity habits.Conclusions This study highlights the combined action of sleep problems and physical activity on fatigue during the onset of induction chemotherapy. These two parameters could represent meaningful intervention targets to improve a patient’s status during chemotherapy.Trial registration The study was registered on the WHO trial register (DRKS00007824).

Defining Cancer Patients As Being in the Terminal Phase: Who Receives a Formal Diagnosis, and What Are the Effects?

2005 ◽  
Vol 23 (30) ◽  
pp. 7411-7416 ◽  
Author(s):  
B. Aabom ◽  
J. Kragstrup ◽  
H. Vondeling ◽  
L.S. Bakketeig ◽  
H. Stovring
Keyword(s):  
Cancer Patients ◽  
Hospital Admissions ◽  
Admission Rate ◽  
The Elderly ◽  
Economic Benefits ◽  
Terminal Phase ◽  
Hospital Death ◽  
Related Factors ◽  
Hematologic Cancer ◽  
Terminal Diagnosis

Purpose Physicians either do not define cancer patients as being terminal, or their prognostic estimates tend to be optimistic. This might affect patients' appropriate and timely referral to specialist palliative care services or can lead to unintended acute hospitalization. Patients and Methods We used the Danish Cancer Register and four administrative registers to perform a retrospective cohort study in 3,445 patients who died as a result of cancer. We used the Danish “terminal declaration” issued by a physician as a proxy for a formal terminal diagnosis (prognosis of death within 6 months). The terminal declaration gives right to economic benefits and increased care for the dying. We investigated patient-related factors of receiving an explicit terminal diagnosis by logistic regression and then analyzed the effects of such a diagnosis on admission rate per week and place of death. Results Thirty-four percent of patients received a formal terminal diagnosis. Age of ≥ 70 years (odds ratio [OR], 0.44; 95% CI, 0.34 to 0.56; P < .001), women (OR, 0.81; 95% CI, 0.69 to 0.96; P = .02), hematologic cancer (OR, 0.20; 95% CI, 0.09 to 0.41; P < .001), and a less than 1-month survival time (OR, 0.10; 95% CI, 0.07 to 0.15; P < .001) were associated with a lesser likelihood of receiving a formal terminal diagnosis. Explicit terminal diagnosis was associated with lower admission rate and an adjusted OR of hospital death of 0.25 (95% CI, 0.21 to 0.29). Conclusion Women and the elderly were less likely to receive a formal terminal diagnosis. The formal terminal diagnosis reduced hospital admissions and increased the possibilities of dying at home.

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