Thirty-Day Mortality Following Systemic Anticancer Therapy: Evaluating Risk Factors Without Selection Bias in a...

Area of Science:

• Oncology
• Clinical Research
• Health Services Research

Background:

• Existing quality indicators for systemic anticancer therapies (SACTs) near death have limitations due to selection bias.
• There is a need for a clinically applicable indicator to assess risk factors associated with SACTs administered close to death.

Purpose of the Study:

• To adapt a previously suggested indicator for evaluating 30-day mortality after SACT in a clinical context.
• To evaluate the adapted indicator in a real-world, population-based cohort of cancer patients.

Main Methods:

• An improved version of the '30-day mortality after SACT' indicator was defined.
• Data from 16,622 SACTs for 10,213 cancer patients in the North Denmark Region (2009-2019) were analyzed.
• The improved indicator's results were compared with a previously suggested indicator.

Main Results:

• The association between clinical variables and 30-day mortality was similar for both indicators, with exceptions in the 75+ age group.
• The improved indicator showed significant variations in 30-day mortality for palliative SACTs across different cancer types.
• A significant downward trend in 30-day mortality following palliative SACT was observed over the study period.

Conclusions:

• An indicator adapted to the clinical context for evaluating 30-day mortality following SACT was successfully defined.
• This indicator can aid in identifying risk factors to support clinical decision-making.
• A notable decrease in 30-day mortality after palliative SACT was observed over 11 years.