Health care utilization and mortality associated with heart failure‐related admissions among cancer patients

Guha, Avirup; Dey, Amit; Armanious, Merna; Dodd, Katherine; Bonsu, Janice M.; Jneid, Hani; Abraham, William T.; Fradley, Michael G.

doi:10.1002/ehf2.12450

Cited by 18 publications

(17 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After detailed variance analyses of the NIS and NRD datasets thus created (Supplemental Methods), survey-specific statements with appropriate patient and hospital level weights were used to obtain national estimates. 10,16 Rao-Scott Chi-square tests were used for comparing categorical variables, and survey specific t -test were used for continuous variables. For tests of trends, we used the Cochrane Armitage test of trend for categorical variables and survey-specific linear regression for continuous variables.…”

Section: Methodsmentioning

confidence: 99%

Contemporary utilization patterns and outcomes of thrombolytic administration for ischemic stroke among patients with cancer

Owusu-Guha

Guha

Miller

et al. 2019

International Journal of Stroke

Self Cite

View full text Add to dashboard Cite

Background Thrombolytic therapy significantly improves outcomes among patients with acute ischemic stroke. While cancer outcomes have dramatically improved, the utilization, safety, and mortality outcomes of patients with cancer who receive thrombolytic therapy for acute ischemic stroke are unknown. Methods Using a national database, we identified all hospitalizations for acute ischemic stroke requiring thrombolytic therapy between 2003 and 2015. Patients with contraindications to thrombolytic therapy were excluded. Following propensity score matching for comorbidity burden, trends in thrombolytic therapy use and its effect on in-hospital mortality, intracranial or all-cause bleeding, and the combined endpoint of mortality and all-cause bleeding, by presence/absence of cancer were evaluated. We also evaluated 30- and 90-day readmission rates post-thrombolytic therapy administration. Results We identified 237,687 acute ischemic stroke hospitalizations requiring thrombolytic therapy, of which 26,328 (11%) had an underlying cancer. Over the study period, thrombolytic therapy use increased across all acute ischemic stroke admissions, irrespective of cancer presence (12.4/1000 in 2003 to 81.1/1000 in 2015, P < 0.0001). However, thrombolytic therapy utilization differed by cancer presence (4.8% cancer vs.·5.1% non-cancer, P = 0.001). There was no difference in intracranial bleeding (9.6% vs. 9.7%), all-cause bleeding (13.2% vs. 13.2%), or in-hospital mortality (7.6% vs. 7.2%). While there was no difference in 30-day readmission rates by cancer presence (24% vs. 29%, P = 0.40), at 90-days, cancer patients saw higher readmission rates (17.2% vs. 13.3%, P = 0.02). Conclusions Contemporary thrombolytic therapy use for acute ischemic stroke has risen, irrespective of presence of cancer. Yet, patients with comorbid cancer appear to see lower rates of thrombolytic therapy use for acute ischemic stroke, despite no difference in the rate of intracranial bleeding or mortality after adjustment for comorbidities.

show abstract

Section: Methodsmentioning

confidence: 99%

Contemporary utilization patterns and outcomes of thrombolytic administration for ischemic stroke among patients with cancer

Owusu-Guha

Guha

Miller

et al. 2019

International Journal of Stroke

Self Cite

View full text Add to dashboard Cite

show abstract

“…Further, it is also possible cancer patients and providers may not have been aware of the spectrum of cardiac (including MI) associated with their treatments, as recently observed. 20 The vulnerability of material, psychological, and behavioral domains of cancer survivors are especially concerning due to the increased risk of late and long-term cardiovascular complication of cancer treatment. Therefore, MI, which is one of the adverse complications of many cancer therapies and an outcome of shared risk factors between cardiovascular disease and cancer, may add immensely to all financial toxicity domains in cancer survivors 7 .…”

Section: Discussionmentioning

confidence: 99%

“…Finally, the derived cost of MI from NIS, even though nationally representative, comes with drawbacks of using weighted stratified sampling technique 20 .…”

Section: Discussionmentioning

confidence: 99%

Socio-Economic Burden of Myocardial Infarction Among Cancer Patients

Guha

Dey

Al‐Kindi

et al. 2021

The American Journal of Cardiology

Self Cite

View full text Add to dashboard Cite

“…We identified all hospitalized adults (≥ 18 years) who had a primary diagnosis (DX1 of NIS) of AF (i.e., incident AF; ICD-9 CM = 427.31) or secondary diagnosis (DX2-DX25) of AF (i.e., comorbid or prevalent AF). Identification of a cancer diagnosis concurrent with the primary diagnosis of AF followed prior validated methodology [11]. Metastatic cancer was excluded from this analysis as resource utilization is expected to be positively skewed in this population leading to overestimation.…”

Section: Methodsmentioning

confidence: 99%

Length of stay and cost of care associated with admissions for atrial fibrillation among patients with cancer

Guha

Jain

Aggarwal

et al. 2022

BMC Cardiovasc Disord

Self Cite

View full text Add to dashboard Cite

Background The aim of this study is to assess the burden of AF-related hospitalizations inclusive of inflation-adjusted cost-of-care and length-of-stay (LOS) among cancer patients and the impact of direct current cardioversion (DCCV) on these outcomes. Methods Using the National Inpatient Sample (NIS), patients hospitalized with either a primary or secondary diagnosis of AF and comorbid cancer were identified and both cost of hospitalization and LOS were evaluated for each group. Subgroup analyses were performed for specific cancer types (breast, lung, colon, prostate and lymphoma), and those receiving DCCV. Results The prevalence of co-morbid AF was 8.2 million (16%) and 35.5 million (10%) among those with vs. those without cancer, respectively (odds ratio = 1.6, 95% confidence interval = 1.5–1.7; P < 0.001). Over time, both primary and prevalent AF admissions among those with comorbid cancer increased from 1.1% and 12.3% in 2003 to 1.5% and 21% in 2015, respectively. The total cost of hospitalization increased 94.4% among those with AF and comorbid cancer compared to 23.9% among those without cancer. Among the subgroup of patients with comorbid cancer and primary admission for AF undergoing DCCV, length of stay (2.7 vs. 2.2 days; P < 0.001, model 1) and cost of care ($7,093 vs. 6,152; P < 0.001) were both significantly higher. Conclusions AF related admissions are increasing for all populations especially amongst those patients with a comorbid diagnosis of cancer, including all cancer subtypes evaluated. Among those patients who underwent DCCV, cancer patients had longer length of stay and increased health care costs.

show abstract

Health care utilization and mortality associated with heart failure‐related admissions among cancer patients

Cited by 18 publications

References 25 publications

Contemporary utilization patterns and outcomes of thrombolytic administration for ischemic stroke among patients with cancer

Contemporary utilization patterns and outcomes of thrombolytic administration for ischemic stroke among patients with cancer

Socio-Economic Burden of Myocardial Infarction Among Cancer Patients

Length of stay and cost of care associated with admissions for atrial fibrillation among patients with cancer

Contact Info

Product

Resources

About