Lymphoma: factors associated with unplanned diagnostic pathways and survival -a nationwide Danish register-based
Linda Aagaard Rasmussen1, Peter Vedsted1,2, Henry Jensen3
1Research Unit for General Practice, Aarhus, Denmark.
Abstract:
The objective was to investigate how patient characteristics, clinical characteristics and prognosis were associated with lymphoma diagnoses in unplanned pathways. We included 7,157 consecutive patients diagnosed with lymphoma in a nationwide register-based study in Denmark. An unplanned pathway was defined as an acute admission within 30 days before diagnosis and compared to all other pathways combined. A total of 21% of patients were diagnosed in unplanned pathways, varying from 13% in indolent non-Hodgkin lymphoma to 32% in aggressive non-Hodgkin lymphoma. The probability of being diagnosed in an unplanned pathway was higher for patients with comorbidity, B-symptoms, abnormal blood test results, advanced disease stage and poor performance score (PS) at diagnosis. Diagnosis in an unplanned pathway was associated with higher mortality, for example, HR 2.03 (95% CI:1.74-2.38 for PS 0). Increased disease severity at diagnosis was associated with unplanned diagnostic pathways. Diagnosis in an unplanned pathway was associated with higher mortality.
