By 2026 the number of prostate cancer survivors is expected to reach 4.5 million. Although the mortality from prostate cancer has been steadily decreasing, cancer survivors usually have poor outcomes compared to their peers without cancer. The majority of the cancer survivors are over the age of 70 and have progressive medical comorbidities. Identifying these comorbidities associated with recurrent hospitalizations might help develop strategies to prevent hospital readmissions among prostate cancer survivors.
Methods:
A retrospective review of medical records was performed at an academic institution for male patients aged 40 years and older who were diagnosed with prostate cancer more than 2 years prior to the study’s observation period from January 2008 to December 2010. Unpaired t-test, and Chi-square tests were used to compare patients’ characteristics and logistic regression models were used to assess risk factors association with recurrent admissions.
Results:
Two hundred and forty-five prostate cancer survivors were stratified by single versus recurrent hospital admission. Most of the characteristics of the study population were similar except that mean Gleason score was lower in the recurrent group, whereas cardiovascular admissions and clinical comorbidities were higher. The most common cause of recurrent admissions was congestive heart failure (14%), followed by upper gastrointestinal bleed (9%), COPD exacerbation (8%), acute renal failure (8%), and pneumonia (7%). In the multivariable regression analyses where socio-demographic, prostate cancer related factors, primary prostate cancer treatment-related sequelae and clinical variables and comorbid conditions were simultaneously analyzed, only congestive heart failure (OR 3.90, 95%CI 1.25 — 12.2) and history of metastasis (OR 8.10, 95%CI 1.10 — 60.1) were statistically significant.
Conclusions:
Our study helps healthcare providers to be more vigilant in managing comorbidities in prostate cancer survivors with congestive heart failure and metastatic disease, which are the most common causes of recurrent admissions in this population. Future studies are needed to evaluate the predictors of hospital readmission in larger national datasets.