Patient-reported global health to predict negative health outcomes in patients with advanced sarcoma.

Abstract

11554 Background: Many patients with sarcoma deal with adverse impacts on their (QoL) related to their underlying disease as well as treatment-related effects. Unplanned hospital admissions and emergency department (ED) visits occur from uncontrolled symptoms that delay treatment and lead to poor hospital system metrics. The PROMIS Global Health v1.2 (PROMIS-10) survey is a validated tool to assess patients’ physical and mental well-being at the time of the survey, with a higher number indicating a better state of health. There are limited studies evaluating longitudinal QoL assessments during sarcoma treatment. Our objective was to analyze PROMIS-10 scores for patients with advanced sarcoma and their temporal relationship with negative outcomes of interest. Methods: We performed a retrospective registry-based longitudinal analysis of routinely collected PROMIS-10 surveys at The Ohio State University. Patients were consented to the sarcoma registry (NCT02677961) from 6/1/2018 to 12/31/2024. We collected baseline, serial and overall change in physical and mental PROMIS-10 raw and normalized t-scores for each patient during their treatment as well as clinical characteristics, mortality, disease progression (RECIST), and ED visits/unplanned hospital admissions. Survival analyses with time-varying covariates were performed using the marginal Cox model approach for statistical analysis. Results: A total of 241 patients were included in the study. Patients with higher PROMIS-10 physical scores had a 13% decrease in risk of death (HR 0.87; P < 0.001), 3% decrease in risk of progression (HR 0.97; P = 0.027), and 6% decrease in risk of ED visit/unplanned hospital admission (HR 0.94; P < 0.001). Patients with a higher PROMIS-10 mental health score had a 7% decrease in risk of death (HR 0.93; P < 0.001), but no association with disease progression or risk of hospital utilization. The larger positive change in physical PROMIS-10 score from baseline to final assessment was associated with an 11% decreased risk of mortality (HR 0.89; P < 0.001) and 9% decreased risk of ED visit/hospital admission (HR 0.91; P = 0.032), but no association with progression. The larger positive change in mental PROMIS-10 score was associated with a 7% decrease in risk of progression (HR 0.93; P = 0.010) but there was no association with mortality or hospital utilization. Conclusions: We demonstrated that obtaining longitudinal patient-reported outcomes to evaluate patients’ physical and mental health during sarcoma treatment can predict mortality, disease progression and ED visits/unplanned hospital admissions. Higher physical PROMIS-10 scores are strongly associated with decreased mortality and hospital utilization risk, whereas a larger positive change in mental PROMIS-10 scores is associated with decreased risk of progression. To our knowledge, this is the largest cohort (241 patients) of advanced sarcoma analyzing QoL impacts.