Journal article
The role of palliative care at the time of stereotactic radiosurgery on healthcare utilization for frail patients with brain metastases
Neuro-oncology advances, v 7(1), pvdaf186
01 Jan 2025
PMID: 40980439
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background. The 5-factor modified frailty index (mFI-5) has been increasingly studied in the context of patients with central nervous system tumors. Previously, studies have demonstrated an inverse relationship between increasing mFI-5 scores and overall/progression-free survival in patients with brain metastases (BMs) undergoing stereotactic radiosurgery (SRS). Methods. A single payer insurance database was queried for patients undergoing SRS for BMs. Patients were stratified based on mFI-5 scores as follows: pre-frail (0-1), frail (2), and severely frail (>= 3). Survival trends and healthcare utilization rates following treatment were analyzed across each frailty group. Results. A total of 9927 patients were retrospectively analyzed. Overall survival (OS) was significantly decreased in the frail and severely frail groups compared to pre-frail patients (frail: HR: 1.55, 95% CI: 1.33-1.80, P < .0001) and (severely frail: HR: 2.12, 95% CI: 1.84-2.44, P < .0001). Increased healthcare utilization was observed after SRS in frail and severely frail patients (frail: 90-day RR 1.07, 180-day RR 1.08. and 1-year RR 1.10, P < .0001; severely frail: 90-day RR 1.16, 180-day RR 1.18, 1-year RR 1.21, P < .0001). In patients with established palliative care involvement at the time of SRS, healthcare utilization rates were decreased in the frail and severely frail groups. Conclusion. Increasing frailty scores portended reduced OS with increased overall healthcare utilization rates.The introduction of palliative care prior to SRS decreased healthcare utilization rates across frailty cohorts.
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Details
- Title
- The role of palliative care at the time of stereotactic radiosurgery on healthcare utilization for frail patients with brain metastases
- Creators
- Trent Kite - Allegheny Health NetworkTeigan Dwyer - Highmark Hlth, Enterprise Analyt, Pittsburgh, PA USACharlotte Drury-Gworek - Highmark Blue Cross Blue ShieldTyson Barrett - Highmark Blue Cross Blue ShieldJohn Herbst - Allegheny Health NetworkRachel Ombres - Highmark Blue Cross Blue ShieldLeah Herbst - Allegheny Health NetworkStephen Karlovits - Allegheny Health NetworkRodney E. Wegner - Allegheny Health NetworkMatthew J. Shepard - Allegheny Health Network
- Publication Details
- Neuro-oncology advances, v 7(1), pvdaf186
- Publisher
- Oxford Univ Press
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001576026300001
- Scopus ID
- 2-s2.0-105016706712
- Other Identifier
- 991022154809504721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Clinical Neurology
- Oncology