Associations between age and patient‐reported outcomes, emergency department visits, and hospitalizations among lung cancer patients receiving immune checkpoint inhibitors

医学 急诊科 肺癌 萧条(经济学) 内科学 比例危险模型 焦虑 急诊分诊台 病历 人口统计学的 生活质量(医疗保健) 回顾性队列研究 急诊医学 精神科 人口学 护理部 经济 社会学 宏观经济学
作者
Sara E. Fleszar‐Pavlović,Akina Natori,Patricia I. Moreno,Heidy N. Medina,Vandana Devika Sookdeo,Jessica MacIntyre,Frank J. Penedo
出处
期刊:Psycho-oncology [Wiley]
卷期号:33 (1)
标识
DOI:10.1002/pon.6293
摘要

Abstract Objective Immune checkpoint inhibitors (ICIs) for lung cancer (LC) treatment have a more favorable safety profile and improved patient reported outcomes (PROs) compared to chemotherapy, suggesting that ICIs are advantageous for older populations. The impact of ICIs on PROs, clinical outcomes, and age in LC patients remains to be established. We examined associations between age and PROs, emergency department (ED) visits, and hospitalizations in LC patients receiving ICIs. Methods We performed retrospective analyses via My Wellness Check ( MWC ), an assessment and triage electronic medical record (EMR) integrated platform in LC patients receiving ICIs. Demographics, clinical characteristics, ED visits, and hospitalizations were extracted via EMR. Patient reported outcomes (PROMIS® anxiety, depression, fatigue, pain, physical function), and health‐related quality of life (HRQOL; FACT‐G7), were collected via MWC . We classified age into three categories (<65, 65–74, ≥75). Multiple regressions examined associations between PROs and age. Cox proportional hazards regressions assessed cumulative ED visits and hospitalizations. Results Among LC patients ( N = 190) receiving ICIs, patients ≥75 had lower depression ( β = −5.80, p = 0.01) and higher HRQOL ( β = 2.47, p = 0.05) compared with patients <65. Relative to patients <65, patients 65–74 had lower anxiety ( β = −3.31, p = 0.05) and pain ( β = −4.18, p = 0.03). Patients 65–74 and ≥ 75 had lower risk of an ED visit (adjusted hazards ratio [aHR] = 0.45, p = 0.05 and aHR = 0.21, p = 0.05, respectively) and patients 65–74 had lower risk of hospitalization (aHR = 0.36, p = 0.02) relative to patients <65. Conclusions Older LC patients (65–74; ≥75) have more favorable PROs and lower risk for negative clinical outcomes than younger (<65) patients.
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