Length of stay and treatment-related complications are similar in pediatric and AYA patients with bone sarcoma in United States children's hospitals

Authors

  • Anthony N. Audino MD,

    1. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio
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  • Nicholas D. Yeager MD,

    1. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio
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  • Lindsey Asti MPH,

    1. College of Public Health, The Ohio State University, Columbus, Ohio
    2. Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's, Hospital, Columbus, Ohio
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  • Yongjie Miao MS, MAS,

    1. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio
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  • Sarah H. O'Brien MD, MSc

    Corresponding author
    1. Division of Pediatric Hematology/Oncology, Nationwide Children's Hospital/The Ohio State University, Columbus, Ohio
    2. Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's, Hospital, Columbus, Ohio
    • Assistant Professor, Pediatric Hematology/Oncology, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205.
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  • Conflict of interest: Nothing to declare.

  • Our work was presented in Abstract form at the 25th American Society of Pediatric Hematology Oncology Annual Meeting (New Orleans, Louisiana, May 9–12, 2012).

Abstract

Background

Adolescent and young adult (AYA) cancer patients have been shown to have unique clinical characteristics and inferior outcomes compared to younger patients. More than 2,500 new bone sarcomas are diagnosed yearly in the US, many of whom are AYAs treated at pediatric hospitals. Pediatric providers must understand the impact of increasing age on complications, costs, and outcomes. The study set-out to determine if AYA patients with bone sarcomas have increased healthcare utilization and treatment-related complications as compared to younger patients.

Procedure

Data were obtained from the Pediatric Health Information System for bone sarcoma admissions at 41 US children's hospitals from 2006 to 2010. Patient demographics and morbidities were compared in patients 0–14 and 15–28 years using two sample t-tests, Wilcoxon two sample tests, or chi-squared tests.

Results

We identified 835 pediatric and 562 AYA patients with bone sarcomas. Mean length of stay (LOS) was comparable between age groups (4.6 and 4.8 days, P = 0.46), although AYA patients had greater mean pharmaceutical charges ($18,124 vs. $13,637, P < 0.0001). Common treatment-related complications were similar between groups, with the exceptions that febrile neutropenia admissions were more likely in younger patients, and thrombosis, renal failure, and pain were more common in AYA patients.

Conclusions

In US children's hospitals, AYA patients with sarcomas do not have prolonged LOS or an increased risk of the most common treatment-related complications as compared to younger patients. Chronic pain appears to be a greater burden in AYA patients, and may account for their higher inpatient pharmaceutical costs. Pediatr Blood Cancer 2013; 60: 415–419. © 2012 Wiley Periodicals, Inc.

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