{"doi":"10.6004/jnccn.2023.7049","title":"Identification and Characterization of Avoidable Hospital Admissions in Patients With Lung Cancer","abstract":"BACKGROUND: More than 50% of patients with lung cancer are admitted to the hospital while receiving treatment, which is a burden to patients and the healthcare system. This study characterizes the risk factors and outcomes of patients with lung cancer who were admitted to the hospital. METHODS: A multidisciplinary oncology care team conducted a retrospective medical record review of patients with lung cancer admitted in 2018. Demographics, disease and admission characteristics, and end-of-life care utilization were recorded. Following a multidisciplinary consensus review process, admissions were determined to be either \"avoidable\" or \"unavoidable.\" Generalized estimating equation logistic regression models assessed risks and outcomes associated with avoidable admissions. RESULTS: In all, 319 admissions for 188 patients with a median age of 66 years (IQR, 59-74 years) were included. Cancer-related symptoms accounted for 65% of hospitalizations. Common causes of unavoidable hospitalizations were unexpected disease progression causing symptoms, chronic obstructive pulmonary disease exacerbation, and infection. Of the 47 hospitalizations identified as avoidable (15%), the median overall survival was 1.6 months compared with 9.7 months (hazard ratio, 2.07; 95% CI, 1.34-3.19; P<.001) for unavoidable hospitalizations. Significant reasons for avoidable admissions included cancer-related pain (P=.02), hypervolemia (P=.03), patient desire to initiate hospice services (P=.01), and errors in medication reconciliation or distribution (P<.001). Errors in medication management caused 26% of the avoidable hospitalizations. Of admissions in patients receiving immunotherapy (n=102) or targeted therapy (n=44), 9% were due to adverse effects of treatment. Patients receiving immunotherapy and targeted therapy were at similar risk of avoidable hospitalizations compared with patients not receiving treatment (P=.3 and P=.1, respectively). CONCLUSIONS: We found that 15% of hospitalizations among patients with lung cancer were potentially avoidable. Uncontrolled symptoms, delayed implementation of end-of-life care, and errors in medication reconciliation were associated with avoidable inpatient admissions. Symptom management tools, palliative care integration, and medication reconciliations may mitigate hospitalization risk.","journal":"Journal of the National Comprehensive Cancer Network","year":2023,"id":354301,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6635,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":530513,"name":"Xuanyi Li","orcid":"0000-0003-3943-4642","position":1,"is_corresponding":false},{"id":361425,"name":"Li‐Ching Huang","orcid":"0000-0002-5959-7097","position":2,"is_corresponding":false},{"id":968652,"name":"Amanda S. Cass","orcid":"0000-0003-1761-4642","position":3,"is_corresponding":false},{"id":395124,"name":"Wade T. Iams","orcid":"0000-0003-2109-298X","position":4,"is_corresponding":false},{"id":1101905,"name":"Emily A. Skotte","orcid":null,"position":5,"is_corresponding":false},{"id":321556,"name":"Jennifer G. Whisenant","orcid":"0000-0002-3435-2464","position":6,"is_corresponding":false},{"id":833250,"name":"Robert A. Ramirez","orcid":"0000-0001-8762-5852","position":7,"is_corresponding":false},{"id":395129,"name":"Sally J. York","orcid":"0009-0005-2194-964X","position":8,"is_corresponding":false},{"id":501473,"name":"Travis Osterman","orcid":"0000-0002-2841-8121","position":9,"is_corresponding":false},{"id":371557,"name":"Jennifer A. Lewis","orcid":"0000-0002-4234-1765","position":10,"is_corresponding":false},{"id":251317,"name":"Christine M. Lovly","orcid":"0000-0002-3641-6361","position":11,"is_corresponding":false},{"id":105129,"name":"Yu Shyr","orcid":"0000-0003-2086-9670","position":12,"is_corresponding":false},{"id":251310,"name":"Leora Horn","orcid":"0000-0003-2070-2547","position":13,"is_corresponding":false},{"id":1101404,"name":"Eric Lander","orcid":"0000-0002-2843-7744","position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T01:13:06.959762Z","pmid":"37856197","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}