The cost of hospitalization secondary to severe chemotherapy induced diarrhea (CID) in patients with colorectal cancer
Bibliographic record
Abstract
6111 Background: Previous studies have suggested that grade III/IV diarrhea is a common complication in colorectal cancer occurring in up to 50% of patients receiving chemotherapy (Arbuckle et al, 2000). In some of these patients, hospitalisation for supportive care is often required. However, the impact that these hospitalised patients have on overall health care resource utilization has not been quantified. In this study, a cost of illness analysis was conducted to estimate the overall cost of patients with colorectal cancer who were hospitalised for supportive care secondary to severe diarrhea. Methods: This was a retrospective cohort study consisting of patients with colorectal cancer that had received fluoropyrimidines alone or in combination with irinotecan or oxaliplatin and had developed grade III or IV diarrhea that resulted in a hospital admission for supportive care. Data collection included patient demographics, disease related information and healthcare resource utilization to manage the grade III/IV CID event. The final sample size for this cohort study was 63 patients resulting in precision that extended to $1,800. Results: Patients had a mean age of 64.2 years and 31 of 63 (49%) were receiving adjuvant chemotherapy with a curative intent. The severe CID developed after the first cycle of chemotherapy in 58% of cases and contributed to a dose reduction, change or discontinuation of chemotherapy in 34%, 15.9% and 34% of patients respectively. Overall, the median length of hospital stay was 8 days (range = 1 to 49 days) translating to a mean cost of $8,230 per patient (95%CI: $6,519 to $9,942). The CID successfully resolved in 54 of 63 patients (85.7%). There were a total of 9 deaths with 7 (11%) possibly being related to the diarrhea. Conclusions: The findings of the current study revealed that severe diarrhea requiring a hospital admission is a costly and potentially fatal complication of chemotherapy in colorectal cancer. The identification of predictive factors and the implementation of prophylactic measures could reduce the morbidity and mortality associated with CID. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Novartis Novartis Canada
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".