Octreotide prescribing patterns in the palliation of symptomatic inoperable malignant bowel obstruction patients at a single U.S. academic hospital.

Abstract

563 Background: Medical management is the cornerstone of malignant bowel obstruction (MBO) therapy and includes antisecretory agents such as octreotide. Currently, little data exist regarding octreotide prescribing patterns in U.S. academic hospitals in the palliation of inoperable MBO. Methods: This retrospective chart review evaluated inpatient with inoperable MBO receiving octretodie at a single academic US hospital (2008-2011). The prescribing primary service (medical vs. surgical), days to initiation of octreotide, daily dose, cumulative dose, length of stay (LOS), and overall survival (OS) were analyzed. Multiple linear regression was used to assess if the association between dose and LOS was significant. Kaplan-Meier curves and log rank test were used to evaluate OS. Results: A total of 767 patients received octreotide. 134 had diagnosis of cancer, and 37 (24 female, 13 male; mean age 56.7 years) had a confirmed inoperable MBO. The mean LOS was equivalent on both services (17 days). The mean octreotide dose was 201.2-μg medical vs. 119-μg surgical. Mean time to initiation was 8.4 days (7.9 medical vs. 8.8 surgical). Earlier initiation was associated with a shorter LOS (Spearman’s correlation= 0.76, p<0.0001). No statistically significant association was demonstrated between OS octreotide dose. Conclusions: Early initiation of octreotide may lead to shorter LOS; the association remains after adjustment for patient age. Timing and dose of octreotide use was not significantly associated with survival.