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Purpose <p>To evaluate whether the first unscheduled hospitalization in advanced cancer may serve as a prognostic indicator of poor survival and a potential trigger for palliative care referral.</p> Methods/patients <p>Retrospective study in two tertiary hospitals using time-separated cohorts, analyzing only each patient’s first unscheduled admission. Primary outcome was post-admission overall survival (OS).</p> Results <p>Median post-admission OS was 164&#xa0;days (95% CI 139–184) in the first cohort (1033 patients) and 108&#xa0;days (95% CI 83–136) in the second cohort (638 patients). Male sex (<i>p</i> &lt; 0.001), older age (<i>p</i> &lt; 0.001), poor performance status (<i>p</i> &lt; 0.001), longer admissions (<i>p</i> &lt; 0.001) and tumor-related admissions (<i>p</i> &lt; 0.001) were associated with lower survival in both cohorts. Previous treatment with immunotherapy (<i>p</i> = 0.003) or targeted therapy (<i>p</i> = 0.002), immunotherapy toxicity as the reason for admission (<i>p</i> &lt; 0.001), and breast (<i>p</i> &lt; 0.001) and gynecological (<i>p</i> &lt; 0.001) cancers were associated with better survival. Cohorts showed consistent baseline characteristics and outcomes.</p> Conclusions <p>In patients with advanced cancer, the first unscheduled hospitalization may serve as a prognostic indicator of poor survival and a potential trigger for palliative care referral.</p>

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First unscheduled hospitalization in advanced cancer as a prognostic indicator of poor survival and trigger for palliative care referral

  • 期刊论文

  • 发表日期：

    2025年7月26日

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  • Alberto Alonso-Babarro,
  • Juan Luis Torres-Tenor,
  • Andrea García-Leal,
  • Darío Sánchez-Cabrero,
  • Lorena Ostios-García,
  • Jesús Miranda-Poma,
  • Laura Gutiérrez-Sainz,
  • Julia Villamayor-Sánchez,
  • José Abelardo Blanco-Iglesias,
  • Javier Mateo-Flores,
  • Adriana Vañó,
  • Eduardo Bruera

摘要

Purpose

To evaluate whether the first unscheduled hospitalization in advanced cancer may serve as a prognostic indicator of poor survival and a potential trigger for palliative care referral.

Methods/patients

Retrospective study in two tertiary hospitals using time-separated cohorts, analyzing only each patient’s first unscheduled admission. Primary outcome was post-admission overall survival (OS).

Results

Median post-admission OS was 164 days (95% CI 139–184) in the first cohort (1033 patients) and 108 days (95% CI 83–136) in the second cohort (638 patients). Male sex (p < 0.001), older age (p < 0.001), poor performance status (p < 0.001), longer admissions (p < 0.001) and tumor-related admissions (p < 0.001) were associated with lower survival in both cohorts. Previous treatment with immunotherapy (p = 0.003) or targeted therapy (p = 0.002), immunotherapy toxicity as the reason for admission (p < 0.001), and breast (p < 0.001) and gynecological (p < 0.001) cancers were associated with better survival. Cohorts showed consistent baseline characteristics and outcomes.

Conclusions

In patients with advanced cancer, the first unscheduled hospitalization may serve as a prognostic indicator of poor survival and a potential trigger for palliative care referral.