Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Office 1R203, Miami, FL, 33176, USA.
Baptist Health South Florida, Miami, FL, USA.
Sci Rep. 2022 Mar 14;12(1):4371. doi: 10.1038/s41598-022-08491-8.
Hospitalizations due to radiotherapy (RT) complications result in significant healthcare expenditures and adversely affect the quality of life of cancer patients. Using a nationally representative dataset, the objective of this study is to identify trends in the incidence of these hospitalizations, their causes, and the resulting financial burden. Data from the National Inpatient Sample was retrospectively analyzed from 2005 to 2016. RT complications were identified using ICD-9 and ICD-10 external cause-of-injury codes. The hospitalization rate was the primary endpoint, with cost and in-hospital death as secondary outcomes. 443,222,223 weighted hospitalizations occurred during the study period, of which 482,525 (0.11%) were attributed to RT. The 3 most common reasons for RT-related hospitalization were cystitis (4.8%, standard error [SE] = 0.09), gastroenteritis/colitis (3.7%, SE = 0.07), and esophagitis (3.5%, SE = 0.07). Aspiration pneumonitis (1.4-fold) and mucositis (1.3-fold) had the highest relative increases among these hospitalizations from 2005 to 2016, while esophagitis (0.58-fold) and disorders of the rectum and anus were the lowest (0.67-fold). The median length of stay of patient for hospitalization for RT complications was 4.1 (IQR, 2.2-7.5) days and the median charge per patient was $10,097 (IQR, 5755-18,891) and the total cost during the study period was $4.9 billion. Hospitalization for RT-related complications is relatively rare, but those that are admitted incur a substantial cost. Use of advanced RT techniques should be employed whenever possible to mitigate the risk of severe toxicity and therefore reduce the need to admit patients.
放疗（RT）并发症导致的住院治疗会产生大量医疗支出，并对癌症患者的生活质量产生不利影响。本研究使用全国代表性数据集，旨在确定这些住院治疗的发生率、原因和由此产生的经济负担的趋势。从 2005 年到 2016 年，对国家住院患者样本进行了回顾性分析。使用 ICD-9 和 ICD-10 外部伤害原因代码来识别 RT 并发症。住院率是主要终点，成本和住院期间死亡是次要结果。在研究期间共发生了 443222300 次加权住院治疗，其中 482525 次（0.11%）归因于 RT。RT 相关住院治疗的 3 个最常见原因是膀胱炎（4.8%，标准误差[SE] = 0.09）、胃肠炎/结肠炎（3.7%，SE = 0.07）和食管炎（3.5%，SE = 0.07）。与 2005 年至 2016 年相比，肺炎吸入（增加 1.4 倍）和黏膜炎（增加 1.3 倍）是这些住院治疗中相对增加最多的原因，而食管炎（减少 0.58 倍）和直肠和肛门疾病是最低的（减少 0.67 倍）。因 RT 并发症住院治疗的患者平均住院时间为 4.1 天（IQR，2.2-7.5），每位患者的平均费用为 10097 美元（IQR，5755-18891），研究期间的总费用为 49 亿美元。因 RT 相关并发症住院治疗相对较少，但住院患者的费用却很高。只要有可能，应采用先进的 RT 技术，以降低严重毒性的风险，从而减少需要住院治疗的患者数量。
