Much of the research in lung cancer is concerning survival or treatment rates and little is known about the rate of hospitalisation (emergency/elective) following the diagnosis of lung cancer.
Newly diagnosed English patients from the National Lung Cancer Audit database (NLCA), 2007–2011, were linked with Hospital Episode Statistics (HES) data to provide details on their subsequent hospital admissions. Hospitalisations for receipt of chemotherapy or cardiothoracic surgery were excluded to ensure only non-treatment related admissions were included. We only included patients included who survived at least 30 days after their first presentation to a physician to exclude more advanced disease. We calculated rates and rate ratios (RR) of elective and emergency admissions per person-year (ppy) by patient features including sex, age, performance status and co-morbidity.
Among 92,482 patients, there were 261,121 non-treatment related hospitalisations with rate of 2.92 admissions ppy (95% CI, 2.91–2.93). Emergency admissions constituted 57% of all admissions at a rate of 1.66 admissions ppy while the elective admission rate was lower at 1.26 admission ppy. Adjusted RRs in Table 1 show that males were approximately 20% more likely than females to be admitted through either route (RR 1.17, 95% CI 1.16 – 1.18 for emergency and 1.20 (1.18–1.21) for elective). Worsening performance status, co-morbidity and advanced stage were all associated with higher emergency admissions while there was no strong association with age. For elective admissions pattern were similar yet associations were weaker and performance status did not show a linear association with admissions. Increasing socioeconomic deprivation was associated with a moderate increase emergency admission rates but a decrease elective admission rates.
The rate of emergency admissions was higher than the rate of elective admissions following diagnosis of lung cancer. Sex, worsening performance status, advanced stage and co-morbidity were all independently associated with admissions with similar patterns for emergency and elective admissions. However, being from a more deprived socioeconomic class was associated with more emergency admissions and fewer elective admissions. Reason for these findings could be related to variation in receiving treatment in these groups or treatment related side effects leading to more emergency admissions.
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