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美国乳腺癌患者中与发热性中性粒细胞减少相关住院治疗的死亡率、住院时间及医疗费用。

Mortality, length of stay, and health care costs of febrile neutropenia-related hospitalizations among patients with breast cancer in the United States.

作者信息

Pathak Ranjan, Giri Smith, Aryal Madan Raj, Karmacharya Paras, Bhatt Vijaya Raj, Martin Mike G

机构信息

Department of Internal Medicine, Reading Health System, 6th Avenue and Spruce St, West Reading, PA, 19611, USA,

出版信息

Support Care Cancer. 2015 Mar;23(3):615-7. doi: 10.1007/s00520-014-2553-0. Epub 2015 Jan 4.

Abstract

PURPOSE

Febrile neutropenia is a potentially life threatening complication of breast cancer chemotherapy associated with a significant amount of morbidity, mortality, and health care resource utilization. Recent data on the national estimates of mortality rate, length of stay, and health care costs among the subpopulation of febrile neutropenia admissions with breast cancer are lacking.

METHODS

We used the Nationwide Inpatient Sample database to identify patients with breast cancer hospitalized for febrile neutropenia from 2009 to 2011. We derived data on inhospital mortality rate, length of stay, and mean health care costs and compared it with previous studies.

RESULTS

The average inhospital mortality rate during 2009-2011 was 2.6 % (n = 685). Advanced age (≥ 65 years) was found to be significantly associated with a higher odds of mortality (4.4 vs 1.7 %, OR 2.7, 95 % CI 2.3-3.1, p < 0.01). The mean length of stay was 5.7 days (95 % CI 5.5-5.9 days), whereas the mean cost of hospitalization was $37,087 (95 % CI $34,009-$40,165).

CONCLUSION

Febrile neutropenia-related hospitalizations continue to account for significant morbidity, mortality, and health care resource utilization among patients with breast cancer. Further efforts should be focused on curtailing the rising health care costs without compromising the quality of care.

摘要

目的

发热性中性粒细胞减少是乳腺癌化疗潜在的危及生命的并发症,伴有大量的发病率、死亡率及卫生保健资源利用。目前缺乏关于乳腺癌发热性中性粒细胞减少住院亚人群死亡率、住院时间及卫生保健费用的全国性估计数据。

方法

我们使用全国住院患者样本数据库,识别2009年至2011年因发热性中性粒细胞减少住院的乳腺癌患者。我们获取了住院死亡率、住院时间及平均卫生保健费用的数据,并与之前的研究进行比较。

结果

2009 - 2011年期间的平均住院死亡率为2.6%(n = 685)。发现高龄(≥65岁)与较高的死亡几率显著相关(4.4%对1.7%,比值比2.7,95%置信区间2.3 - 3.1,p < 0.01)。平均住院时间为5.7天(95%置信区间5.5 - 5.9天),而平均住院费用为37,087美元(95%置信区间34,009 - 40,165美元)。

结论

发热性中性粒细胞减少相关住院在乳腺癌患者中继续导致显著的发病率、死亡率及卫生保健资源利用。应进一步努力在不影响护理质量的情况下控制不断上升的卫生保健费用。

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