Mortality in cancer patients after a fall-related injury: The impact of cancer spread and type

Abstract

Background: Cancer patients are at an increased risk of dying following an injury, of which among the elderly is predominately caused by falling. In addition, patients with certain types of cancer are more prone to bone injury. However, studies are needed that examine the role of cancer site and metastasis on the relationship between cancer and death following traumatic injury.

Methods: A total of 4201 cancer patients from 2000 to 2009 in the Illinois Hospital Discharge and Illinois Trauma Registry, and 4201 patients without cancer met eligibility criteria (e.g., fell and were injured; 50-96 years old). A multivariable logistic regression analysis was conducted to assess the relationship between cancer and death following traumatic injury, including models stratified by cancer site and metastasis.

Results: The demographic characteristics, prevalence of comorbid conditions, and injury severity and type did not differ substantially between patients with and without diagnoses for cancer. In the main adjusted model, patients with cancer were more likely to die during the course of hospitalization after a fall than those without cancer (OR=2.58; CI 95%: 1.91-3.49). Patients with metastatic malignancies had a higher risk of in-hospital death than patients without metastasis (adjusted OR=3.59 and OR=2.18, respectively). Patients with diagnoses for all specific cancer sites, except prostate and breast, were also significantly more likely to die.

Discussion: Cancer patients with and without spread over the age of 50 years are more likely to die in-hospital after a fall than elderly patients without cancer. However, this relationship may exist only for patients with specific cancer types.

Keywords: Cancer; Cancer type; Elderly; Falls; Metastasis; Mortality.