Article Abstract

Hospitalizations in elderly glioblastoma patients

Authors: Claire Moroney, James R. Perry, Derek S. Tsang, Denise Bilodeau, Chris Mueller, Hany Soliman, Sten Myrehaug, Arjun Sahgal, Chia-Lin Tseng, May N. Tsao


Background: Elderly glioblastoma (GB) patients are at risk of hospitalizations due to the morbidity of the disease and possible treatment toxicity.
Methods: In this observational cohort study, 255 newly diagnosed GB patients age 65 years and older were included. Survival, emergency room visits and admissions to an acute care hospital were determined. Mean and median total health care costs were calculated. Risk factors for Emergency room visits and acute care hospital admissions were determined.
Results: Median overall survival was 6 months. The majority of patients (68%) had at least one visit to the emergency department and 77% had at least one admission to acute care. The mean and median total costs (hospital, ambulatory, physician billing, other health care costs) per patient were $162,479.78 (CAN) and $125,511.00 (CAN), respectively. Treatment with radiation or treatment with radio-chemotherapy was associated with a relative risk (RR) of 2.31 (95% CI: 1.44–3.7; P=0.0005) and 2.19 (95% CI: 1.28–3.74; P=0.004), respectively for emergency department visits as compared to patients who were managed with comfort measures only. Patients with a baseline ECOG 0 had a RR of 1.71 (95% CI: 1.06–2.77; P=0.0289) and patients with baseline ECOG 1 had a RR of 1.49 (0.98–2.26; P=0.0623) for hospital admission as compared to patients with ECOG 4.
Conclusions: A large proportion of elderly GB patients (particularly those with good baseline performance status who underwent active treatment) presented to the emergency department and had at least one admission to acute care.