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Psychosocial Factors Associated With High Readmission Rates, Longer Hospital Stays

Ashley RoskoA study by OSUCCC – James researchers shows that psychosocial risk factors that affect a person’s ability to cope with chronic stress are associated with significantly higher readmission rates and longer hospital stays among blood cancer patients undergoing hematopoietic stem cell transplantation (HSCT).

The researchers say that this demonstrates a critical need that should be addressed in a systematic way by the oncology community.

“Stem cell transplant can be a curative treatment for certain cancers, but it is a long process that can place severe strains on patients,” says senior author Ashley Rosko, MD, an OSUCCC – James hematologist.

“Just like we assess potential impact and risks of a patient’s co-morbidities before pursuing a stem cell transplant, we saw a need to evaluate psychosocial vulnerabilities to identify those patients at the highest risk for complications and to develop interventions to ensure the smoothest recovery possible.”

The observational study examined 395 patients undergoing stem-cell transplantation for acute leukemia, multiple myeloma, lymphoma and other cancers at the OSUCCC – James.

Prior to treatment, all patients were screened to identify factors affecting their ability to cope, including history of anxiety, depression, substance abuse, health behaviors, family social support, emotional tone and mental status. Patients deemed at-risk were subcategorized into mild and moderate risk.

The researchers found 48 percent of the patients to be at risk. The most common identified risk factors were psychiatric conditions (24 percent), poor health behaviors (16 percent) and poor coping history (13 percent).

“Hospital readmission in stem cell transplant patients is associated with poor overall survival, increased cost and worse quality of life,” says Rosko. “It is important that we do all we can to identify these patients in advance to help them successfully navigate the treatment process."

Presented at the 2016 American Society of Hematology meeting.

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