Abstract B117: Disparities in non-surgical admissions for survivors of cervical cancer: Understanding morbidity and survivorship needs through hospital admissions

Abstract

Abstract Purpose: To utilize data on hospital admissions among patients with cervical cancer during treatment and long-term surveillance to better understand disease and treatment related burdens, explore inpatient utilization of services, and identify risk factors for admission. Methods: Retrospective chart review was performed on patients treated for cervical cancer from 2014 to 2020 at a single academic institution. Clinical, demographic and treatment information and hospital admission characteristics were collected. Discharge diagnoses were grouped and summarized with descriptive statistics. Univariate and multivariate regression were used to examine associations between patient characteristics and likelihood of admission. Results: Of 366 patients identified, 188 (51%) were admitted to the hospital for cancer or treatment-related reasons excluding planned admissions for initial treatment, in the median follow-up period of 3.6 years (IQR 1.4-6.4), with a median number of 2 admissions (IQR 1-4) and median length of stay 4 days (IQR 2-7). Of those admitted, 65 (35%) had discharge diagnoses belonging to more than one clinical category. The five most common discharge diagnoses were gastrointestinal problems (40%), genitourinary problems (35%), infection (35%), pain control (21%), and vaginal bleeding (19%). A significant proportion of admitted patients underwent inpatient interventions including imaging (68%), surgical procedures (57%), antibiotics (52%), transfusion of blood products (40%), and interventional radiology procedures (28%) and utilized supportive and specialty care including case management (53%), physical therapy (40%), occupational therapy (36%), social work (36%), nutrition (31%), and palliative care (23%). On univariate analysis, Black patients (OR 3.0, p<.001), uninsured patients (OR 5.2, p<.001), those with lower performance status (OR 1.7, p<.001), higher stage (OR 2.9, p<.001), patients who received radiation or chemoradiation (OR 3.9, p<.001), and those with recurrence (OR 5.1, p<.001) were more likely to be hospitalized after completion of treatment. On multivariate analysis, odds of admission were higher among Black patients (aOR 2.4, p<.01), uninsured patients (aOR 2.7, p<.05), those with lower performance status (aOR 2.7, p<.05), and those with recurrence (aOR 5.5, p<.001). Conclusion: Patients with cervical cancer represent a high-risk population frequently hospitalized after initial treatment, due to disease and treatment-related toxicities. Black patients, uninsured patients, those with recurrence, and those with lower performance status faced higher odds of admission, possibly reflecting higher survivorship burden. Comprehensive, team-based approaches to address complex symptom burden are needed for this high risk group. Patient-reported outcomes and needs assessments should also be considered to design programming to address complex needs in this patient population. Citation Format: Rayne Peerenboom, Sarah Ackroyd, Chuanhong Liao, Aarthi Koripelly, Nita Lee. Disparities in non-surgical admissions for survivors of cervical cancer: Understanding morbidity and survivorship needs through hospital admissions [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B117.