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Febrile neutropenia-related care and associated costs in elderly patients with breast cancer, lung cancer, or non-Hodgkin lymphoma.

老年乳腺癌、肺癌或非霍奇金淋巴瘤患者发热性中性粒细胞减少症相关护理及相关费用。

  • 影响因子:2.83
  • DOI:10.1007/s00520-019-04795-0
  • 作者列表:"Li S","Liu J","Bowers C","Garawin TAFS","Kim C","Bensink ME","Chandler DB
  • 发表时间:2020-01-01
Abstract

PURPOSE:Limited information is available regarding elderly patients experiencing febrile neutropenia (FN). This study evaluated FN-related care among elderly cancer patients who received high/intermediate FN-risk chemotherapy and experienced ≥ 1 FN episodes. METHODS:We used Medicare data to identify patients aged ≥ 66 years who initiated high/intermediate FN-risk chemotherapy between 1 January 2008 and 31 August 2015 to treat breast cancer (BC), lung cancer (LC), or non-Hodgkin lymphoma (NHL) and had ≥ 1 FN episodes. We identified within-cycle FN episodes for each chemotherapy cycle on Part A inpatient claims or outpatient or Part B claims. We described the FN-related care setting (inpatient hospital, outpatient emergency department [ED], or outpatient non-ED) and reported mean total cost of FN-related care per episode overall and by care setting (adjusted to 2015 US$). RESULTS:We identified 2138, 3521, and 2862 patients with BC, LC, and NHL, respectively, with ≥ 1 FN episodes (total episodes: 2407, 3840, 3587, respectively). Most FN episodes required inpatient care (BC, 88.1%; LC, 93.0%; NHL, 93.2%) with mean hospital length of stay (LOS) 6.2, 6.5, and 6.8 days, respectively. Intensive care unit admission was required for 20.4% of BC, 29.0% of LC, and 25.7% of NHL hospitalizations (mean LOS: 4.7, 4.7, 5.5 days, respectively). The mean total cost of FN care per episode was $11,959 BC, $14,388 LC, and $15,006 NHL, with inpatient admission the costliest care component ($11,826; $14,294; and $14,873; respectively). CONCLUSIONS:Among elderly patients with BC, LC, or NHL who experienced FN, most FN episodes required costly hospital care, highlighting the FN burden on healthcare systems.

摘要

目的: 关于出现发热性中性粒细胞减少症 (FN) 的老年患者的信息有限。本研究在接受高/中危FN化疗并经历 ≥ 1 次FN发作的老年癌症患者中评估了FN相关护理。 方法: 我们使用医疗保险数据来确定年龄 ≥ 66 岁的患者,这些患者在 2008 年 1 月 1 日至 20 15 年 8 月 31 日期间开始使用高/中风险FN化疗来治疗乳腺癌 (BC),肺癌 (LC) 或非霍奇金淋巴瘤 (NHL),且有 ≥ 1 次FN发作。我们在A部分住院索赔或门诊或B部分索赔中确定了每个化疗周期的周期内FN发作。我们描述了FN相关的护理设置 (住院医院,门诊急诊科 [ED] 或门诊非ED) 并报告了每次发作FN相关护理的平均总费用和护理设置 (调整至 2015 美元)。 结果: 我们分别确定了 2138,3521 和 2862 例BC,LC和NHL患者,≥ 1 次FN发作 (总发作分别为 2407,3840,3587)。大多数FN发作需要住院治疗 (BC,88.1%; LC,93.0%; NHL,93.2%),平均住院时间 (LOS) 分别为 6.2 、 6.5 和 6.8 天。20.4% 的BC、 29.0% 的LC和 25.7% 的NHL住院需要重症监护病房 (平均LOS分别为 4.7 、 5.5 天)。每集FN护理的平均总费用为 11,959 美元BC,14,388 美元LC和 15,006 美元NHL,住院治疗是最昂贵的护理部分 (11,826 美元; 14,294 美元; 和 14,873 美元; 分别)。 结论: 在经历FN的老年BC,LC或NHL患者中,大多数FN发作需要昂贵的医院护理,突出了FN对医疗保健系统的负担。

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肺肿瘤,又叫支气管肺癌,是常见的恶性肿瘤之一。肺肿瘤的治疗为包括手术、中药、放疗、化疗及免疫等多学科的综合治疗。

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