A detailed insight in the high risks of hospitalizations in long-term childhood cancer survivors-A Dutch LATER linkage study

Dutch LATER Study Grp, Nina Streefkerk, Wim J. E. Tissing, Joke C. Korevaar, Eline van Dulmen-den Broeder, Dorine Bresters, Margriet van der Heiden-van der Loos, Marry M. van de Heuvel-Eibrink, Flora E. Van Leeuwen, Jacqueline Loonen, Helena H. J. van der Pal, Cecile M. Ronckers, A. Brigitte Versluys, Andrica C. H. de Vries, Elizabeth A. M. Feijen, Leontine C. M. Kremer*

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

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    Abstract

    Background

    Insight in hospitalizations in long-term childhood cancer survivors (CCS) is useful to understand the impact of long-term morbidity. We aimed to investigate hospitalization rates and underlying types of diagnoses in CCS compared to matched controls, and to investigate the determinants.

    Methods

    We linked 5,650 five-year CCS from the Dutch nationwide Dutch LATER cohort and 109,605 age- and sex-matched controls to the Dutch Hospital Discharge register, which contained detailed information on inpatient hospitalizations from 1995-2016. Relative hospitalization rates (RHRs) were calculated using a Poisson regression model. Adjusting for multiple hospitalizations per person via a Poisson model for generalized estimated equations, we investigated determinants for hospitalizations for all types of underlying diagnoses among CCS.

    Results

    CCS were twice as likely to be hospitalized as reference persons (hospitalization rate 178 and 78 per 1,000 person-years respectively; RHR 2.0, 95% confidence interval (CI) 1.9-2.2). Although CCS had more hospitalizations for 17 types of underlying diagnoses, they were especially more likely to be hospitalized for endocrine conditions (RHR: 6.0, 95% CI 4.6-7.7), subsequent neoplasms (RHR: 5.6, 95% CI 4.6-6.7) and symptoms without underlying diagnoses (RHR: 5.2, 95% CI 4.6-5.8). For those types of underlying diagnoses, female sex and radiotherapy were determinants.

    Conclusion

    This study provides new insights in the high risk of hospitalizations for many types of underlying diagnoses in CCS and treatment related determinants. CCS are especially at high risk for hospitalizations for endocrine conditions, subsequent neoplasms and symptoms without an underlying diagnosis. This new knowledge is important for survivorship care and to identify possible preventable hospitalizations among CCS.

    Original languageEnglish
    Article number0232708
    Number of pages18
    JournalPLoS ONE
    Volume15
    Issue number5
    DOIs
    Publication statusPublished - 19-May-2020

    Keywords

    • QUALITY-OF-LIFE
    • SECONDARY LEUKEMIA
    • HEALTH OUTCOMES
    • GROWTH-HORMONE
    • ADULT CANCER
    • POPULATION
    • COHORT
    • ADOLESCENT
    • RADIATION
    • SERVICE

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