Trends in adverse events related to immunosuppressive treatments among patients with head and neck cancer and their impact on the burden of illness.

Abstract

e23100 Background: Immunosuppressive cancer therapy has significantly transformed care, particularly for patients with head and neck cancers (HNC). Nonetheless, adverse events (AEs) continue to affect patient outcomes. Comprehending the adverse events (AEs) and discrepancies in their utilization and management among HNC patients is essential for enhancing patient outcomes. To prevent these occurrences and enhance its utilization, we must comprehend the differences among cancer patients who do and do not encounter adverse events connected to immunosuppressive medication. Methods: This research employed the National Inpatient Sample database to examine AEs among HNC patients in 2021, as well as to analyze the pattern of cost utilization related to AEs, notably ulcerative mucositis, from 2016 to 2020. The relationship between burden of illness (BOI)—length of stay (LOS), discharge dispositions, mortality, septicemia, emergency admissions, and illness burden was analyzed using generalized linear models (GLM) and further assessed by propensity score analysis. Results: In 2021, we identified 5,125 (weighted, original estimates) patients with adverse events among 57,615 (weighted, original estimates) head and neck cancer patients receiving immunosuppressive treatment. In the adjusted analysis patients with immunosuppressive AEs were associated with longer LOS (Coeff: 1.15; 95%CI: 1.02-1.31), higher coagulopathies (aOR 1.88, 95% Cl:1.53-2.31), weekend admission (1.29, 95%CI: 1.02-1.64); weight loss (aOR: 1.35, 95%CI: 1.16-1.57); ulcerative mucositis (UM) (aOR 33.63, 95% Cl:1.92-58.7). Estimating the 2016-2021 trend analysis, the presence of a positive Radiation-UM status was associated with a longer LOS, but a lower total charge for Radiation-UM patients receiving CLOP treatment (LOS, coefficient: 1.33, 95%CI: 1.14-1.55) (total charges, coefficient, 0.67, 95% CI:0.56-0.81). In addition, women, Blacks, Hispanics, and patients with Medicaid insurance all face a higher level of disparity in terms of the BOI associated with mucositis. And these AEs patients were referred to aftercare facility than home. Conclusions: These results aid in detecting trends and discrepancies influencing adverse event treatment among head and neck cancer patients. Additional research is required to identify the obstacles contributing to these discrepancies. This big-data research utilizes real-world data to examine the outcomes, complications, treatment breaks and disparities encountered by patients with HNC AEs Challenges related to AEs in cancer treatment and access to care continue; nonetheless, additional research and execution of care are essential.