Assessing the risk of chemotherapy toxicity and hospital admission due to toxicity: A study of acute chemotherapy toxicity and related hospital admission in a large UK teaching hospital, based on proactive telephone assessment patients

Abstract

Introduction: Acute chemotherapy toxicity is common and can have negative effects for the patient and health economy and hospitalisation can be necessitated. Aims: To identify the incidence of toxicity and admission, and predictors of toxicity occurrence, severity, hospitalisation and length of stay. Method: Data was obtained from a proactive telephone assessment of acute toxicity 24 hours after administration of a first cycle of chemotherapy to patients in a large UK NHS teaching hospital. Results: 1539 patients were studied and the overall incidence of toxicity was 35.6% (530 patients). Disease site and number of chemotherapy agents given were shown to predict toxicity, with breast and upper gastrointestinal cancers having a higher likelihood of toxicity. Disease was predictive of toxicity grade, with urology, gynaecology and lung cancer patients experiencing higher grades of toxicity than other tumour sites. The rate of hospital admission due to toxicity was 13.1% (203 patients) and median length of stay 3 days (1-28). The risk of admission had some risk factors in common with toxicity. Disease and the number of drugs in the regimen affected the risk of admission, with gynaecology, head and neck and lung cancer patients and patients who received 3 drugs having a higher likelihood of admission. Predictors in the subgroups of breast, colorectal and lung cancer patients did not differ greatly from the whole population and the number of drugs was shown to be a predictor of nausea, vomiting and fatigue when explored as secondary outcomes. Conclusion: The research partly addressed the main aim and highlighted areas where further research is required. Keywords