Comparison of hospital course of geriatric inpatients with or without active cancer: a bicentric case-control study

Abstract

Background: The hospital course of older patients with cancer hospitalized in geriatrics units remain poorly known. The aim of our study was to compare the clinical characteristics and hospital courses of geriatric inpatients with or without active cancer.

Methods: A case-control study was conducted in 2013 in the geriatric acute care units of Angers University Hospital and Le Mans Hospital, France, to compare 204 consecutive cases with cancer (mean age, 85.4±5.5 years; 42.6% male) and 1,020 controls without active cancer (mean age, 85.5±5.8 years; 42.6% male) matched for age, gender, recruitment period and center. Hospital courses were evaluated by the length of hospital stay and the in-hospital mortality. The place of life, body mass index, cumulative illness rating scale-geriatrics (CIRS-G) score, history of falls, and reason for admission were used as covariates.

Results: Cases with active cancer exhibited a higher (i.e., worse) CIRS-G score (p<0.001) and were hospitalized more often for an organic failure (p<0.001) than controls. The hospital stay of cases was longer (16.3±13.0 days versus 12.6±9.4 days, p<0.001), and their in-hospital mortality rate was higher than controls (23.5% versus 5.6%, p<0.001). After adjustment, having an active cancer was associated with increased length of hospital stay (β=3.3, p<0.001) and greater in-hospital mortality (OR=4.4, p<0.001).

Conclusion: The length of hospital stay and in-hospital mortality rate were greater in geriatric patients with active cancer compared to controls, which reflects more complicated hospital courses in this population.

Keywords: care pathway; hospital stay; in-hospital mortality; older adults; oncology.