Cancer Care Services, Toowoomba Hospital, Toowoomba, Australia.
Rural Clinical School, Faculty of Medicine, The University of Queensland Toowoomba, Toowoomba, Australia.
J Oncol Pharm Pract. 2022 Jul;28(5):1077-1084. doi: 10.1177/10781552211016086. Epub 2021 May 14.
To retrospectively determine the rate of death occurring within 14 and 30 days of systemic anticancer therapy (SACT), compare this against a previous audit and benchmark results against other cancer centres. Secondly, to determine if the introduction of immune checkpoint inhibitors (ICI), not available at the time of the initial audit, impacted mortality rates.
All adult solid tumour and haematology patients receiving SACT at an Australian Regional Cancer Centre (RCC) between January 2016 and July 2020 were included.
Over a 55-month period, 1709 patients received SACT. Patients dying within 14 and 30 days of SACT were 3.3% and 7.0% respectively and is slightly higher than our previous study which was 1.89% and 5.6%. Mean time to death was 15.5 days. Males accounted for 63.9% of patients and the mean age was 66.8 years. 46.2% of the 119 patients dying in the 30 days post SACT started a new line of treatment during that time. Of 98 patients receiving ICI, 22.5% died within 30 days of commencement. Disease progression was the most common cause of death (79%). The most common place of death was the RCC (38.7%).
The rate of death observed in our re-audit compares favourably with our previous audit and is still at the lower end of that seen in published studies in Australia and internationally. Cases of patients dying within 30 days of SACT should be regularly reviewed to maintain awareness of this benchmark of quality assurance and provide a feedback process for clinicians.
回顾性分析全身抗癌治疗（SACT）后 14 天和 30 天内的死亡率，与之前的审计结果进行比较，并与其他癌症中心的结果进行基准比较。其次，确定在最初的审计中不可用的免疫检查点抑制剂（ICI）的引入是否影响了死亡率。
纳入 2016 年 1 月至 2020 年 7 月期间在澳大利亚区域癌症中心（RCC）接受 SACT 的所有成年实体瘤和血液学患者。
在 55 个月的时间里，共有 1709 名患者接受了 SACT。SACT 后 14 天和 30 天内死亡的患者分别为 3.3%和 7.0%，略高于我们之前的研究（分别为 1.89%和 5.6%）。平均死亡时间为 15.5 天。男性占患者的 63.9%，平均年龄为 66.8 岁。在 SACT 后 30 天内死亡的 119 名患者中有 46.2%在此期间开始了新的治疗线。在接受 ICI 的 98 名患者中，有 22.5%在开始 SACT 后 30 天内死亡。疾病进展是最常见的死亡原因（79%）。最常见的死亡地点是 RCC（38.7%）。
我们重新审核的死亡率与我们之前的审核结果相比表现良好，并且仍处于澳大利亚和国际上已发表研究报告的死亡率的较低水平。应定期审查 SACT 后 30 天内死亡的患者病例，以保持对这一质量保证基准的认识，并为临床医生提供反馈过程。
