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Saxena A, Rubens M, Ramamoorthy V, Tonse R, Veledar E, McGranaghan P, Sundil S, Chuong MD, Hall MD, Odia Y, Mehta MP, Kotecha R. Hospitalization rates for complications due to systemic therapy in the United States. Sci Rep 2021; 11:7385. [PMID: 33795827 PMCID: PMC8016938 DOI: 10.1038/s41598-021-86911-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/22/2021] [Indexed: 11/15/2022] Open
Abstract
The aim of this study was to estimate the trends and burdens associated with systemic therapy-related hospitalizations, using nationally representative data. National Inpatient Sample data from 2005 to 2016 was used to identify systemic therapy-related complications using ICD-9 and ICD-10 external causes-of-injury codes. The primary outcome was hospitalization rates, while secondary outcomes were cost and in-hospital mortality. Overall, there were 443,222,223 hospitalizations during the study period, of which 2,419,722 were due to complications of systemic therapy. The average annual percentage change of these hospitalizations was 8.1%, compared to - 0.5% for general hospitalizations. The three most common causes for hospitalization were anemia (12.8%), neutropenia (10.8%), and sepsis (7.8%). Hospitalization rates had the highest relative increases for sepsis (1.9-fold) and acute kidney injury (1.6-fold), and the highest relative decrease for dehydration (0.21-fold) and fever of unknown origin (0.35-fold). Complications with the highest total charges were anemia ($4.6 billion), neutropenia ($3.0 billion), and sepsis ($2.5 billion). The leading causes of in-hospital mortality associated with systemic therapy were sepsis (15.8%), pneumonia (7.6%), and acute kidney injury (7.0%). Promoting initiatives such as rule OP-35, improving access to and providing coordinated care, developing systems leading to early identification and management of symptoms, and expanding urgent care access, can decrease these hospitalizations and the burden they carry on the healthcare system.
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Affiliation(s)
- Anshul Saxena
- Baptist Health South Florida, Miami, FL, USA
- Florida International University, Miami, FL, USA
| | - Muni Rubens
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | | | - Raees Tonse
- Baptist Health South Florida, Miami, FL, USA
| | - Emir Veledar
- Baptist Health South Florida, Miami, FL, USA
- Florida International University, Miami, FL, USA
| | - Peter McGranaghan
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Subrina Sundil
- Southeastern Regional Medical Center, Lumberton, NC, USA
| | - Michael D Chuong
- Florida International University, Miami, FL, USA
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Matthew D Hall
- Florida International University, Miami, FL, USA
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Yazmin Odia
- Florida International University, Miami, FL, USA
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Minesh P Mehta
- Florida International University, Miami, FL, USA
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA
| | - Rupesh Kotecha
- Florida International University, Miami, FL, USA.
- Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, USA.
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Wooldridge LM, Kangas BD. An assay of drug-induced emesis in the squirrel monkey (Saimiri sciureus). J Med Primatol 2019; 48:236-243. [PMID: 30968960 DOI: 10.1111/jmp.12411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/07/2019] [Accepted: 03/10/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Emesis has significant evolutionary value as a defense mechanism against ingested toxins; however, it is also one of the most common adverse symptoms associated with both disease and medical treatments of disease. The development of improved antiemetic pharmacotherapies has been impeded by a shortage of animal models. METHODS The present studies characterized the responses of the squirrel monkey to pharmacologically diverse emetic drugs. Subjects were administered nicotine (0.032-0.56 mg/kg), lithium chloride (150-250 mg/kg), arecoline (0.01-0.32 mg/kg), or apomorphine (0.032-0.32 mg/kg) and observed for emesis and prodromal hypersalivation. RESULTS Nicotine rapidly produced emesis and hypersalivation. Lithium chloride produced emesis with a longer time course without dose-dependent hypersalivation. Arecoline produced hypersalivation but not emesis. Apomorphine failed to produce emesis or hypersalivation. CONCLUSIONS The squirrel monkey is sensitive to drug-induced emesis by a variety of pharmacological mechanisms and is well-positioned to examine antiemetic efficacy and clinically important side effects of candidate antiemetic pharmacotherapies.
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Affiliation(s)
| | - Brian D Kangas
- Behavioral Biology Program, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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