Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio, USA.
Pediatr Blood Cancer. 2013 Mar;60(3):415-9. doi: 10.1002/pbc.24231. Epub 2012 Jun 15.
Adolescent and young adult (AYA) cancer patients have been shown to have unique clinical characteristics and inferior outcomes compared to younger patients. More than 2,500 new bone sarcomas are diagnosed yearly in the US, many of whom are AYAs treated at pediatric hospitals. Pediatric providers must understand the impact of increasing age on complications, costs, and outcomes. The study set-out to determine if AYA patients with bone sarcomas have increased healthcare utilization and treatment-related complications as compared to younger patients.
Data were obtained from the Pediatric Health Information System for bone sarcoma admissions at 41 US children's hospitals from 2006 to 2010. Patient demographics and morbidities were compared in patients 0-14 and 15-28 years using two sample t-tests, Wilcoxon two sample tests, or chi-squared tests.
We identified 835 pediatric and 562 AYA patients with bone sarcomas. Mean length of stay (LOS) was comparable between age groups (4.6 and 4.8 days, P = 0.46), although AYA patients had greater mean pharmaceutical charges ($18,124 vs. $13,637, P < 0.0001). Common treatment-related complications were similar between groups, with the exceptions that febrile neutropenia admissions were more likely in younger patients, and thrombosis, renal failure, and pain were more common in AYA patients.
In US children's hospitals, AYA patients with sarcomas do not have prolonged LOS or an increased risk of the most common treatment-related complications as compared to younger patients. Chronic pain appears to be a greater burden in AYA patients, and may account for their higher inpatient pharmaceutical costs.
与年轻患者相比，青少年和年轻成人（AYA）癌症患者具有独特的临床特征和较差的预后。在美国，每年诊断出超过 2500 例新的骨肉瘤，其中许多是在儿童医院接受治疗的 AYA。儿科医生必须了解年龄增长对并发症、成本和结果的影响。本研究旨在确定与年轻患者相比，患有骨肉瘤的 AYA 患者是否有更多的医疗保健利用和与治疗相关的并发症。
数据来自 2006 年至 2010 年美国 41 家儿童医院的儿科健康信息系统的骨肉瘤住院患者数据。使用两样本 t 检验、Wilcoxon 两样本检验或卡方检验比较 0-14 岁和 15-28 岁患者的患者人口统计学和合并症。
我们确定了 835 名儿科和 562 名患有骨肉瘤的 AYA 患者。两组患者的平均住院时间（LOS）相似（分别为 4.6 和 4.8 天，P=0.46），尽管 AYA 患者的药品费用平均值较高（18124 美元对 13637 美元，P<0.0001）。两组之间常见的治疗相关并发症相似，但有两个例外，即年轻患者更容易发生发热性中性粒细胞减少症入院，而 AYA 患者更常见血栓形成、肾衰竭和疼痛。
在美国儿童医院，与年轻患者相比，患有肉瘤的 AYA 患者的 LOS 没有延长，也没有增加最常见的治疗相关并发症的风险。慢性疼痛似乎对 AYA 患者来说是一个更大的负担，这可能解释了他们更高的住院药品费用。
