External Validation of Risk Factors for Unplanned Hospitalization in Older Adults With Advanced Cancer Receiving...

Area of Science:

• Geriatric Oncology
• Clinical Epidemiology
• Health Services Research

Background:

• Older adults undergoing chemotherapy are susceptible to unplanned hospitalizations, impacting treatment outcomes and healthcare costs.
• Previous research identified key predictors of hospitalization in this vulnerable population.
• External validation of these predictors is crucial for reliable risk assessment.

Purpose of the Study:

• To validate previously identified predictors of unplanned hospitalization in older adults receiving chemotherapy for advanced cancer.
• To assess the association between specific risk factors and hospitalization within three months of treatment initiation.

Main Methods:

• A validation cohort of 369 patients aged ≥70 years with incurable cancer initiating chemotherapy was analyzed.
• Seven previously identified risk factors (comorbidities, albumin, creatinine clearance, cancer type, medications, ADLs, social support) were assessed.
• Multivariable logistic regression and ROC curve analysis (AUC) were used to evaluate model performance.

Main Results:

• Unplanned hospitalization occurred in 29% of patients within three months.
• Higher numbers of risk factors correlated with increased hospitalization odds (47% for 6-7 factors).
• Impaired Activities of Daily Living (ADLs) and low albumin levels (<3.5 g/dL) were significant predictors (ORs 1.76 and 2.23, respectively).
• The model's discriminative ability (AUC) was 0.65.

Conclusions:

• The number of identified risk factors is associated with unplanned hospitalizations in older adults receiving chemotherapy.
• Impaired ADLs and low albumin are key drivers of this association.
• Validated predictors can enhance patient counseling and shared decision-making regarding cancer treatment.