1. Risk of emergency hospitalisation and survival outcomes following adjuvant chemotherapy for early breast cancer in New South Wales, Australia.
- Author
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Tervonen HE, Chen TYT, Lin E, Boyle FM, Moylan EJ, Della-Fiorentina SA, Beith J, Johnston A, and Currow DC
- Subjects
- Adult, Aged, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carboplatin administration & dosage, Chemotherapy, Adjuvant, Chemotherapy-Induced Febrile Neutropenia epidemiology, Chemotherapy-Induced Febrile Neutropenia etiology, Cohort Studies, Cyclophosphamide administration & dosage, Docetaxel administration & dosage, Emergencies, Female, Fever chemically induced, Humans, Infections chemically induced, Kaplan-Meier Estimate, Logistic Models, Mastectomy, Mastectomy, Segmental, Middle Aged, Neutropenia chemically induced, New South Wales epidemiology, Odds Ratio, Proportional Hazards Models, Retrospective Studies, Risk Factors, Trastuzumab administration & dosage, Antineoplastic Combined Chemotherapy Protocols adverse effects, Breast Neoplasms drug therapy, Fever epidemiology, Hospitalization statistics & numerical data, Infections epidemiology, Neutropenia epidemiology, Survival Rate
- Abstract
Objective: To examine risk of emergency hospital admission and survival following adjuvant chemotherapy for early breast cancer., Methods: Linked data from New South Wales population-based and clinical cancer registries (2008-2012), hospital admissions, official death records and pharmaceutical benefit claims. Women aged ≥18 years receiving adjuvant chemotherapy for early-stage operable breast cancer in NSW public hospitals were included. Odds ratios (OR) for emergency hospitalisation within 6 months following chemotherapy initiation were estimated using logistic regression and survival using Kaplan-Meier and Cox proportional hazards methods., Results: A total of 3,950 women were included and 30.6% were hospitalised. The most common principal diagnosis at admission was neutropenia (30.8%). Women receiving docetaxel/carboplatin/trastuzumab (TCH) and docetaxel/cyclophosphamide (TC) were the most frequently hospitalised. After adjustment for demographic and clinical factors, the increased risk of hospitalisation for TCH and TC remained compared with doxorubicin/cyclophosphamide 3-weekly (OR 1.71, 95% confidence interval [CI] 1.24-2.37 and OR 1.47, 95% CI 1.17-1.85 respectively). Five-year overall survival was similar for women who were (92.2%, 95% CI 90.7-93.8) and were not hospitalised (93.1%, 95% CI 92.1-94.1)., Conclusion: Emergency hospitalisations following chemotherapy for early breast cancer were relatively common, especially following docetaxel-containing protocols. Further examination of reasons for admission is needed to inform actions to improve patient safety., (© 2019 John Wiley & Sons Ltd.)
- Published
- 2019
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