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Independent Predictors for Hospitalization-Associated Radiation therapy Interruptions
Adam Hubler1, Daniel V Wakefield1,2, Lydia Makepeace1
1Department of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee.
Advances in Radiation Oncology
|September 26, 2022
Summary
Hospitalization-associated radiation therapy interruptions (HARTI) impact over 5% of patients, disproportionately affecting socioeconomically disadvantaged groups. Interventions are needed to reduce these disruptions and ensure equitable care.
Area of Science:
- Oncology
- Health Services Research
- Radiotherapy
Background:
- Radiation treatment interruptions due to unplanned hospitalizations are understudied.
- Understanding hospitalization-associated radiation therapy interruptions (HARTI) is crucial for patient care continuity.
Purpose of the Study:
- To determine the frequency of HARTI.
- To identify causes of hospitalization during radiation therapy.
- To find factors predicting HARTI and associated neighborhood environments.
Main Methods:
- Retrospective review of electronic health records.
- Logistic regression to identify predictive factors for HARTI.
- Geospatial mapping of HARTI events by patient residence.
Main Results:
- HARTI occurred in 5.3% of patients, with 727 missed treatments.
- Common causes included malnutrition/dehydration, respiratory distress/infection, and fever/sepsis.
- Predictive factors included African-American race, Medicaid/uninsured status, specific cancer types (lung, head and neck), and high treatment fraction prescriptions.
Conclusions:
- HARTI disproportionately affects socioeconomically disadvantaged urban patients.
- Geospatial analysis revealed risks for middle-income suburban patients, independent of race or insurance.
- Further studies are needed to guide interventions for equitable HARTI reduction.
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