Geriatric Assessment, Hospitalization, and Long-Term Care Use in Older Cancer Survivors
In a study reported in the Journal of Oncology Practice, Williams et al found that items in geriatric assessment were significantly predictive of hospitalization frequency and long-term care use among older cancer survivors.
Study Details
The study included 125 patients aged ≥ 65 years from the Carolina Senior Registry and North Carolina Central Cancer Registry who had geriatric assessment performed between 3 months before through 6 months after cancer diagnosis. Participants were required to have continuous enrollment in both Medicare parts A and B and no enrollment in managed care plans for 6 months before and after cancer diagnosis.
Patients were followed for hospitalizations and long-term care use (skilled nursing or assisted living) for up to 5 years after diagnosis. Patients had a mean age of 74 years; 80% were female, 90% were white, 64% had breast cancer, and 77% had stage 0 to III cancers.
Factors Associated With Hospitalization and Long-Term Care
Geriatric assessment items significantly associated with increased frequency of hospitalization were:
- Prefrail/frail status (relative risk [RR] = 2.5, P < .001)
- Instrumental activities of daily living impairment (RR = 5.47, P < .001)
- Limitations in climbing stairs (RR = 2.94, P < .001).
Increased use of long-term care was significantly associated with:
- Prefrail/frail status (RR = 1.86, P < .007)
- Instrumental activities of daily living impairment (RR = 4.58, P < .001)
- Falls (RR = 6.73, P < .001)
- Prolonged Timed Up and Go test (RR = 5.45, P < .001)
- Limitations in climbing stairs (RR = 1.89, P < .005).
The investigators concluded, “[Geriatric assessment]–identified impairments were associated with increased hospitalizations and long-term care use among older adults with cancer. [Geriatric assessment]–focused interventions should be targeted toward high-risk patients to reduce long-term adverse health-care use in this vulnerable population.”
Grant R. Williams, MD, of the University of Alabama at Birmingham, is the corresponding author for the Journal of Oncology Practice article.
Disclosure: The study was supported by the Walter B. Frommeyer Fellowship in Investigative Medicine at University of Alabama at Birmingham, the Breast Cancer Research Foundation (New York), the University Cancer Research Fund at University of North Carolina, and the Clinical and Translational Science Award program of the National Center for Advancing Translational Sciences (National Institutes of Health). The study authors’ full disclosures can be found at jop.ascopubs.org.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
