Armideo Erin, Froio Shannon, Johnson Meredith, Tardino-Gingrich Alison, Froh Elizabeth
Children's Hospital of Philadelphia, Pennsylvania.
J Adv Pract Oncol. 2022 Mar;13(2):143-149. doi: 10.6004/jadpro.2022.13.2.5. Epub 2022 Mar 25.
The purpose of this study is to describe the outcomes following the implementation of an early discharge protocol for pediatric patients with osteosarcoma receiving high-dose methotrexate (MTX) to determine if the protocol safely decreased length of stay without increased toxicity.
This was a retrospective descriptive cohort design. Participants included children, 5 to 25 years of age, diagnosed with osteosarcoma, who received methotrexate between December 2017 and July 2019. A total of 141 doses across fifteen individual patients were included in the cohort. Data were abstracted from the electronic health record and analyzed using descriptive statistics.
The majority of administrations (n = 94, 67%) met early discharge criteria without an increase in toxicity or hospital readmission.
Pediatric patients receiving high-dose MTX for osteosarcoma can be safely discharged from the hospital when serum MTX level < 0.4 μmol/L with the implementation of education, hydration goals, frequent lab monitoring, and close follow-up. More than half of patients on this study were able to be discharged from the hospital sooner than prior protocol. More importantly, this retrospective chart review highlighted the ability to maintain safe administration without increasing toxicity.
本研究旨在描述对接受大剂量甲氨蝶呤（MTX）治疗的骨肉瘤患儿实施早期出院方案后的结果，以确定该方案是否能在不增加毒性的情况下安全缩短住院时间。
这是一项回顾性描述性队列研究设计。研究对象包括2017年12月至2019年7月期间诊断为骨肉瘤并接受甲氨蝶呤治疗的5至25岁儿童。该队列共纳入15例患者的141剂药物。数据从电子健康记录中提取，并使用描述性统计进行分析。
大多数给药（n = 94，67%）符合早期出院标准，且毒性或再次入院率未增加。
通过实施教育、补液目标、频繁实验室监测和密切随访，血清甲氨蝶呤水平<0.4 μmol/L时，接受大剂量MTX治疗骨肉瘤的儿科患者可安全出院。本研究中超过一半的患者比之前的方案更早出院。更重要的是，这项回顾性病历审查突出了在不增加毒性的情况下维持安全给药的能力。
