Prolonged hospitalization of advanced cancer patients linked to physical, psychological symptom burden

New research indicates that hospitalized patients with advanced cancer experience many physical and psychological symptoms, and that patients dealing with a higher burden of these symptoms have longer hospital stays and a greater risk for unplanned hospital readmissions. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings highlight the critical need to develop and test interventions to lessen these patients' symptoms.

Patients with advanced cancer often experience frequent and prolonged hospitalizations for reasons that have not been fully explored. To investigate, Ryan Nipp, MD, MPH, of Massachusetts General Hospital and his colleagues collected self-reported physical and psychological symptoms from 1036 patients with advanced cancer as they were being admitted for an unplanned hospitalization. The researchers examined the relationship between patients' symptom burden, the duration of their hospital stay, and risk for later readmission.

More than half of patients reported moderate or severe fatigue, poor well-being, drowsiness, pain, and lack of appetite. Also, 29 percent and 28 percent of patients had depression and anxiety symptoms, respectively. Average hospital stay was 6.3 days and the readmission rate within 90 days of discharge was 43.1 percent. Physical symptoms, psychological distress, and depression symptoms were linked with longer hospital stays. Physical and anxiety symptoms were linked with a higher likelihood of readmission.

"We demonstrated that many hospitalized patients with advanced cancer experience an immense physical and psychological symptom burden," said Dr. Nipp. "Interventions to identify and treat symptomatic patients hold great potential for improving patients' experience with their illness, enhancing their quality of life, and reducing their health care utilization."