This Article Full Text Full Text (PDF) Submit a response to this article Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Alert me to new issues of the journal Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Krzyzanowska, M. K. Articles by Jacobson, J. O. Search for Related Content PubMed Articles by Krzyzanowska, M. K. Articles by Jacobson, J. O. Social Bookmarking                            What's this?

Development of a Patient Registry to Evaluate Hospital Admissions Related to Chemotherapy Toxicity in a Community Cancer Center¹

Center for Outcomes and Policy Research, Dana Farber Cancer Institute, Boston, MA; and North Shore Medical Center Cancer Center, Peabody, MA.

Corresponding Author: Joseph Jacobson, MD, MSc Department of Medicine, Salem Hospital, 81 Highland Avenue, Salem, MA 01970, jjacobson{at}partners.org

PURPOSE: Most chemotherapy (CT) administration occurs in routine care settings, yet little is known about treatment-related toxicity outside of clinical trials. To examine trends in toxicity, modify practice, and establish benchmarks for severe toxicity in a community cancer center we created a prospective registry of all treatment-related hospitalizations at the North Shore Medical Center Cancer Center, a community-based cancer facility in Peabody, MA.

METHODS: Eligible population consisted of all adult cancer patients admitted to the hospital within 30 days of their last CT administration. Each admission was reviewed by a panel of hospital staff to determine whether admission was treatment-related. Information on admission was collected using a standard form.

RESULTS: Between October 2001 and December 2003, there were 365 hospitalizations among patients receiving CT, 117 (32%) of which were deemed treatment-related. The median age of the cohort with treatment-related toxicity was 67 years, and 41% were male. Most frequent diagnoses were non-Hodgkin's lymphoma (23%) and colorectal cancer (21%), with 49% of the patients receiving treatment with palliative intent. The most common reasons for admission were gastrointestinal toxicity or infection. The mean length of stay was 7.1 days. Seven patients (6%) died during hospitalization. When the registry was reviewed to identify areas where care may be improved, several admissions for decadron-related hyperglycemia in nondiabetic patients with myeloma were noted. This led to introduction of glucose monitoring guidelines with no subsequent admissions for this toxicity since then.

CONCLUSIONS: About one third of hospital admissions in patients receiving CT are treatment-related and most occur in patients with advanced disease. Collection of data on toxicity in the routine care setting is feasible and may facilitate quality improvement.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?