Pain, palliation, and opioid use patterns: A nationwide analysis of neoplasm-related pain admissions and trends (2016-2020)

Document Type

Conference Proceeding

Publication Date

5-29-2024

Publication Title

J Clin Oncol

Abstract

Background: Neoplasm-related pain (NRP) remains a significant contributor to the diminished quality of life in cancer patients. We aimed to study the epidemiological characteristics and trends among patients hospitalized for NRP from 2016 to 2020. Methods: A retrospective study of patients hospitalized for primary or secondary diagnosis of NRP from 2016-2020 was conducted using the National Inpatient Sample (NIS) database. Temporal trends in the prevalence, mortality rate (MR), length of stay (LOS), hospitalization cost, palliative care consults, and opioid use/dependence/abuse (OUD) were assessed using linear regression or the Cochran- Armitage test. Further, the NIS database was searched to identify all patients admitted with a diagnosis of OUD. Amongst them, the proportion of patients with a coexisting diagnosis of NRP was calculated. Analysis was done using R 4.3.2 and SAS 9.4. Results: 174,530 cases with NRP were identified from 2016-2020, with a median age at hospitalization of 61(IQR: 52,70). The number of hospitalizations increased from 28,036 in 2016 to 41,013 in 2019 and then dropped to 38,040 in 2020 (p < 0.001). The total inpatient MR was 7.8%, decreasing from 8.5%in 2017 to 7.0% in 2020 (p < 0.0001). The mean cost of hospitalization increased significantly from $64,162.5 in 2016 to $82,943.8 in 2020 (p<0.001). There was no significant change in the mean LOS. The number of palliative care consults increased from 29.8% in 2016 to 31.5% in 2019 and then dropped to 31.3% in 2020 (p < 0.001). Among 174,530 NRP patients, 5,844 (3.4%) had a coexisting diagnosis of OUD, which increased from 832 (3.0%) in 2016 to 1419 (3.7%) in 2020 (p < 0.001). A total of 737,971 patients with a diagnosis of OUD were admitted from 2016-2020, of which 5844 (0.79%) had a coexisting diagnosis of NRP. Conclusions: We observed increased hospitalizations for NRP and related palliative care consults from 2016 to 2019, with a subsequent decline in 2020. This drop could be related to the impact of the COVID-19 pandemic. Despite the rise in the cost of hospitalizations, there has been a declining trend in MR, potentially due to improved quality of care. The gradual rise in the coexistence of OUD among NRP patients is notable. Yet, NRP patients remain a minority within the broader context of OUD-related admissions, underscoring the need for nuanced, patient-centered approaches in NRP management. (Table Presented).

Volume

42

Issue

16

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