Open AccessA detailed insight in the high risks of hospitalizations in long-term childhood cancer survivors—A Dutch LATER linkage study
Author(s) -
Nina Streefkerk,
Wim J. E. Tissing,
Joke C. Korevaar,
Eline van Dulmen–den Broeder,
Dorine Bresters,
Margriet van der Heidenvan der Loo,
Marry M. van de Heuvel-Eibrink,
Flora E. van Leeuwen,
Jacqueline Loonen,
Helena H J van der Pal,
Cécile M. Ronckers,
A. B. Versluys,
Andrica C H de Vries,
Elizabeth A M Feijen,
Leontien C. M. Kremer
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232708
Subject(s) - medicine , poisson regression , medical diagnosis , confidence interval , pediatrics , cohort study , cancer , cohort , relative risk , demography , population , environmental health , pathology , sociology
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.