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Inpatient folate testing at an academic cancer center: single-year experience.
Supportive Care in Cancer ( IF 2.8 ) Pub Date : 2020-01-03 , DOI: 10.1007/s00520-019-05267-1
Zachary D Epstein-Peterson 1 , Diane G Li 2, 3 , Jessica A Lavery 2 , Brooke Barrow 2, 4 , Ishita Chokshi 5 , Deborah Korenstein 1, 3, 6
Affiliation  

PURPOSE The value of testing for folate deficiency has been scrutinized recently given low prevalence of deficiency with widespread dietary fortification. Numerous studies have shown folate testing to be low yield overall. However, the value of such testing in the inpatient cancer population has not been defined. METHODS We queried all folate tests performed during 2017 at our center on admitted cancer patients. We used diagnosis codes and manual chart review to assess risk factors for folate deficiency. Descriptive statistics were used to summarize characteristics of patients undergoing folate testing, the frequency of vitamin B12 co-testing, and repeat folate testing. Fisher's exact test was used to compare the proportion of deficient vs. not deficient tests based on the presence of risk factors. A Cox proportional hazards model was fit to examine the association between folate deficiency and survival. RESULTS In total, 937 patients had 1065 tests performed during 2017. Among all tests, 7.0% indicated folate deficiency. In patients who underwent two folate tests in a single hospitalization, 89% were deficient neither instance. Risk factors for folate deficiency were equally common in instances with deficient compared with replete testing (25.3 vs. 20.4%, P = 0.334). Folate deficiency was associated with higher risk for death (HR 1.49, 95% CI 1.10-2.03, P = 0.01). CONCLUSION Folate deficiency was present in 7% of hospitalized cancer patients and associated with shorter overall survival. Repeat testing in the same patient over time was low yield. Traditional risk factors for folate deficiency do not appear to apply in this patient population.

中文翻译:

在学术癌症中心进行住院叶酸检测:单年经验。

目的 叶酸缺乏症检测的价值最近得到了仔细审查,因为缺乏症的流行率较低,而且膳食强化很普遍。许多研究表明,叶酸测试总体上产量低。然而,这种检测在住院癌症人群中的价值尚未确定。方法 我们查询了 2017 年在我们中心对入院癌症患者进行的所有叶酸测试。我们使用诊断代码和手动图表审查来评估叶酸缺乏的风险因素。描述性统计用于总结接受叶酸检测的患者的特征、维生素 B12 联合检测的频率以及重复叶酸检测的频率。基于风险因素的存在,Fisher 精确检验用于比较缺陷与不缺陷测试的比例。Cox 比例风险模型适用于检查叶酸缺乏与生存之间的关联。结果 2017 年共有 937 名患者进行了 1065 次测试。在所有测试中,7.0% 表明叶酸缺乏。在一次住院期间接受两次叶酸检测的患者中,89% 的患者均未缺乏。与完全检测相比,叶酸缺乏的风险因素在缺乏的情况下同样常见(25.3 对 20.4%,P = 0.334)。叶酸缺乏与较高的死亡风险相关(HR 1.49,95% CI 1.10-2.03,P = 0.01)。结论 7% 的住院癌症患者存在叶酸缺乏症,并且与较短的总生存期相关。随着时间的推移,对同一名患者进行重复测试的产量很低。
更新日期:2020-01-04
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