BACKGROUND Inpatient supportive care programs often target patients with advanced solid tumors. To the authors' knowledge, few studies to date have characterized symptom burden in hospitalized patients with potentially curable cancers. The objective of the current study was to compare symptom burden, palliative care consultation, and readmission rates in hospitalized patients by cancer type and treatment intent. METHODS The authors conducted a single-center study of hospitalized patients with cancer between 2014 and 2017. They assessed physical symptoms using the Edmonton Symptom Assessment System and psychological distress using the Patient Health Questionnaire-4 and the Primary Care PTSD (Posttraumatic Stress Disorder) Screen. Multivariate linear regression models were used to assess symptom burden, logistic regression was used to assess palliative care use, and competing risk regression was used to compare 90-day readmission risk. RESULTS A total of 1549 patients were enrolled and surveyed. The majority of patients reported moderate to severe fatigue, poor well-being, and drowsiness with no significant differences noted by cancer type and treatment intent. Compared with other groups, patients with incurable solid cancer reported higher physical symptoms (beta coefficient [B], 4.73; P < .01) and symptoms of depression (B, 0.44; P < .01) and anxiety (B, 0.39; P < .01), but no difference in posttraumatic stress disorder. Among patients in the top quartile symptom burden according to the Edmonton Symptom Assessment System, the palliative care service was consulted in 14.7%, 7.9%, 25.0%, and 49.6%, respectively, of patients with potentially curable hematologic, potentially curable solid, incurable hematologic, and incurable solid cancers (P < .001). Compared with patients with potentially curable solid cancer, patients in each group experienced a higher risk of readmission within 90 days. CONCLUSIONS Hospitalized patients with cancer experience substantial physical and psychological symptoms. Palliative care rarely is consulted for highly symptomatic patients with potentially curable cancers. Supportive care interventions should target the needs of symptomatic patients regardless of treatment intent.

中文翻译：

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计划外住院的癌症患者的症状负担。

背景技术住院支持治疗计划通常针对晚期实体瘤患者。据作者所知，迄今为止，几乎没有任何研究能够表征可能治愈的癌症住院患者的症状负担。本研究的目的是根据癌症类型和治疗意图比较住院患者的症状负担，姑息治疗咨询和再入院率。方法作者对2014年至2017年间住院的癌症患者进行了单中心研究。他们使用埃德蒙顿症状评估系统评估了身体症状，并使用《患者健康问卷-4》和《初级保健PTSD（创伤后应激障碍）筛查》评估了心理困扰。 。使用多元线性回归模型评估症状负担，逻辑回归分析用于评估姑息治疗的使用，竞争风险回归分析用于比较90天再入院的风险。结果共有1549例患者入选并进行了调查。大多数患者报告中度至重度疲劳，健康状况不佳和嗜睡，但癌症类型和治疗意图无明显差异。与其他组相比，无法治愈的实体癌患者的身体症状（β系数[B]，4.73； P <.01）和抑郁症状（B，0.44； P <.01）和焦虑症（B，0.39； P）更高。 <.01），但创伤后应激障碍无差异。根据Edmonton症状评估系统，在四分位数症状最重的患者中，姑息治疗服务的咨询比例分别为14.7％，7.9％，25.0％和49.6％，患有潜在可治愈的血液学，潜在可治愈的实体，不可治愈的血液学和不可治愈的实体癌的患者的比例（P <.001）。与可能治愈的实体癌患者相比，每组患者在90天内再次入院的风险更高。结论住院的癌症患者会经历大量的生理和心理症状。对于症状严重，可能治愈的患者，很少咨询姑息治疗。无论治疗目的如何，支持治疗干预措施应针对有症状患​​者的需求。每组患者在90天内再次入院的风险较高。结论住院的癌症患者会经历大量的生理和心理症状。对于症状严重，可能治愈的患者，很少咨询姑息治疗。无论治疗目的如何，支持治疗干预措施应针对有症状患​​者的需求。每组患者在90天内再次入院的风险较高。结论住院的癌症患者会经历大量的生理和心理症状。对于症状严重，可能治愈的患者，很少咨询姑息治疗。无论治疗目的如何，支持治疗干预措施应针对有症状患​​者的需求。