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Article ; Online: Derivation and Validation of the Cancer READMIT Score: A Readmission Risk Scoring System for Patients With Solid Tumor Malignancies.

Manzano, Joanna-Grace M / Lin, Heather / Zhao, Hui / Halm, Josiah / Suarez-Almazor, Maria E

2021 Volume 18, Issue 1, Page(s) e117–e128

Abstract: Purpose: Readmissions for the medical treatment of cancer have traditionally been excluded from readmission measures under the Hospital Readmissions Reduction Program. Patients with cancer often have higher readmission rates and may need heightened ... ...

Abstract	Purpose: Readmissions for the medical treatment of cancer have traditionally been excluded from readmission measures under the Hospital Readmissions Reduction Program. Patients with cancer often have higher readmission rates and may need heightened support to ensure effective care transitions after hospitalization. Estimating readmission risk before discharge may assist in discharge planning efforts and help promote care coordination at time of discharge. Patients and methods: We developed and validated a readmission risk scoring system among a cohort of adult cancer patients with solid tumor admitted at a comprehensive cancer center. Multivariate logistic regression analysis was used to develop the model. The model's discriminative capacity was evaluated through a receiver operating characteristic curve analysis. We further compared the performance of the developed score with existing risk scores for 30-day readmission. Results: The 30-day unplanned readmission rate in the total cohort was 16.0% (n = 1,078 of 6,720). After multivariate analysis, Cancer site, Recent emergency room visit within 30 days, non-English primary language, Anemia defined as hemoglobin < 10 g/dL, > 4 Days length of stay during the index admission, unmarried Marital status, Increased white blood cell count > 11 × 10 Conclusion: The Cancer READMIT score was able to predict 30-day unplanned readmissions to our institution with fairly modest performance. External validation of our derived risk scoring system is recommended.
MeSH term(s)	Hospitalization ; Humans ; Neoplasms/therapy ; Patient Discharge ; Patient Readmission ; Risk Factors
Language	English
Publishing date	2021-08-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.20.01077
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Article ; Online: Treatment patterns and outcomes of high-grade immune checkpoint inhibitor-related pneumonitis in an oncology hospitalist service.

Manzano, Joanna-Grace M / Sahar, Hadeel / Aldrich, Jeffrey / Lu, Maggie / Shoukier, Mahran / Peterson, Christine B / Dickson, Kodwo / Koom-Dadzie, Kwame / Kheder, Ed / Franco Vega, Maria C / Mohammed, Alyssa / Muthu, Mayoora / Simbaqueba, Cesar / Senechalle, Michelle Sibille / Brito-Dellan, Norman

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2024 Volume 32, Issue 3, Page(s) 160

Abstract: Purpose: Immune checkpoint inhibitors (ICI) have become standard of care for some types of lung cancer. Along with expanding usage comes the emergence of immune-related adverse events (irAEs), including ICI-related pneumonitis (ICI-P). Treatment ... ...

Abstract	Purpose: Immune checkpoint inhibitors (ICI) have become standard of care for some types of lung cancer. Along with expanding usage comes the emergence of immune-related adverse events (irAEs), including ICI-related pneumonitis (ICI-P). Treatment guidelines for managing irAEs have been developed; however, how clinicians manage irAEs in the real-world setting is less well known. We aimed to describe the outcomes and care patterns of grade ≥ 3 ICI-P in an onco-hospitalist service. Patients and methods: We included patients with lung cancer treated with ICI who were admitted to an oncology hospitalist service with a suspicion of ICI-P. We described the hospitalization characteristics, treatment patterns, discharge practices, and clinical outcomes of patients with confirmed ICI-P. The primary outcome was time to start treatment for ICI-P. Results: Among 49 patients admitted with a suspicion of ICI-P, 31 patients were confirmed to have ICI-P and subsequently received ICI-P directed treatment. Pulmonology was consulted in 97% of patients. Median time to start treatment for ICI-P was 1 day (IQR 0-3.5 days). All 31 patients received corticosteroids. Inpatient mortality was 32%. Majority of patients discharged with steroids were prescribed prophylaxis for gastritis and opportunistic infections. Thirty-eight percent of patients were seen by pulmonology and 86% were seen by the oncology team post-discharge. Conclusion: Our study confirms prior findings of high mortality among patients with high-grade ICI-P. Early diagnosis and treatment are key to improving clinical outcomes. Understanding the care patterns and adherence to treatment guidelines of clinicians caring for this patient population may help identify ways to further standardize management practices and improve patient outcomes.
MeSH term(s)	Humans ; Patient Discharge ; Aftercare ; Hospitalists ; Immune Checkpoint Inhibitors/adverse effects ; Pneumonia/chemically induced ; Lung Neoplasms/drug therapy ; Retrospective Studies
Chemical Substances	Immune Checkpoint Inhibitors
Language	English
Publishing date	2024-02-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-024-08361-1
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Zs.A 3697: Show issues

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Article ; Online: Understanding Potentially Preventable 7-day Readmission Rates in Hospital Medicine Patients at a Comprehensive Cancer Center.

Leung, Cerena K / Walton, Natalie C / Kheder, Ed / Zalpour, Ali / Wang, Justine / Zavgorodnyaya, Daria / Kondody, Sonia / Zhao, Christina / Lin, Heather / Bruera, Eduardo / Manzano, Joanna-Grace M

American journal of medical quality : the official journal of the American College of Medical Quality

2023 Volume 39, Issue 1, Page(s) 14–20

Abstract: This study aimed to describe the potentially preventable 7-day unplanned readmission (PPR) rate in medical oncology patients. A retrospective analysis of all unplanned 7-day readmissions within Hospital Medicine at MD Anderson Cancer Center from ... ...

Abstract	This study aimed to describe the potentially preventable 7-day unplanned readmission (PPR) rate in medical oncology patients. A retrospective analysis of all unplanned 7-day readmissions within Hospital Medicine at MD Anderson Cancer Center from September 1, 2020 to February 28, 2021, was performed. Readmissions were independently analyzed by 2 randomly selected individuals to determine preventability. Discordant reviews were resolved by a third reviewer to reach a consensus. Statistical analysis included 138 unplanned readmissions. The estimated PPR rate was 15.94%. The median age was 62.50 years; 52.90% were female. The most common type of cancer was noncolon GI malignancy (34.06%). Most patients had stage 4 cancer (69.57%) and were discharged home (64.93%). Premature discharge followed by missed opportunities for goals of care discussions were the most cited reasons for potential preventability. These findings highlight areas where care delivery can be improved to mitigate the risk of readmission within the medical oncology population.
MeSH term(s)	Humans ; Female ; Middle Aged ; Male ; Retrospective Studies ; Patient Readmission ; Hospital Medicine ; Inpatients ; Patient Discharge ; Risk Factors ; Neoplasms/therapy
Language	English
Publishing date	2023-12-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1131772-3
ISSN	1555-824X ; 1062-8606
ISSN (online)	1555-824X
ISSN	1062-8606
DOI	10.1097/JMQ.0000000000000157
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Zs.A 2436: Show issues

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Article ; Online: Sclerosing mesenteritis following immune checkpoint inhibitor therapy.

Kuang, Andrew G / Sperling, Gabriel / Liang, Tom Z / Lu, Yang / Tan, Dongfeng / Bollin, Kathryn / Johnson, Douglas B / Manzano, Joanna-Grace M / Shatila, Malek / Thomas, Anusha S / Thompson, John A / Zhang, Hao Chi / Wang, Yinghong

Journal of cancer research and clinical oncology

2023 Volume 149, Issue 11, Page(s) 9221–9227

Abstract: Purpose: Sclerosing mesenteritis (SM), a fibroinflammatory process of the mesentery, can rarely occur after immune checkpoint inhibitor (ICI) therapy; however, its clinical significance and optimal management are unclear. We aimed to assess the ... ...

Abstract	Purpose: Sclerosing mesenteritis (SM), a fibroinflammatory process of the mesentery, can rarely occur after immune checkpoint inhibitor (ICI) therapy; however, its clinical significance and optimal management are unclear. We aimed to assess the characteristics and disease course of patients who developed SM following ICI therapy at a single tertiary cancer center. Methods: We retrospectively identified 12 eligible adult cancer patients between 05/2011 and 05/2022. Patients' clinical data were evaluated and summarized. Results: The median patient age was 71.5 years. The most common cancer types were gastrointestinal, hematologic, and skin. Eight patients (67%) received anti-PD-1/L1 monotherapy, 2 (17%) received anti-CTLA-4 monotherapy, and 2 (17%) received combination therapy. SM occurred after a median duration of 8.6 months from the first ICI dose. Most patients (75%) were asymptomatic on diagnosis. Three patients (25%) reported abdominal pain, nausea, and fever and received inpatient care and corticosteroid treatment with symptom resolution. No patients experienced SM recurrence after the completion of corticosteroids. Seven patients (58%) experienced resolution of SM on imaging. Seven patients (58%) resumed ICI therapy after the diagnosis of SM. Conclusions: SM represents an immune-related adverse event that may occur after initiation of ICI therapy. The clinical significance and optimal management of SM following ICI therapy remains uncertain. While most cases were asymptomatic and did not require active management or ICI termination, medical intervention was needed in select symptomatic cases. Further large-scale studies are needed to clarify the association of SM with ICI therapy.
MeSH term(s)	Immune Checkpoint Inhibitors/adverse effects ; Immune Checkpoint Inhibitors/therapeutic use ; Mediastinitis/diagnostic imaging ; Mediastinitis/drug therapy ; Mediastinitis/immunology ; Sclerosis/diagnostic imaging ; Sclerosis/drug therapy ; Sclerosis/immunology ; Humans ; Male ; Female ; Middle Aged ; Aged ; Neoplasms/drug therapy ; Retrospective Studies ; Adrenal Cortex Hormones/therapeutic use
Chemical Substances	Immune Checkpoint Inhibitors ; Adrenal Cortex Hormones
Language	English
Publishing date	2023-05-17
Publishing country	Germany
Document type	Journal Article
ZDB-ID	134792-5
ISSN	1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
ISSN (online)	1432-1335
ISSN	0171-5216 ; 0084-5353 ; 0943-9382
DOI	10.1007/s00432-023-04802-2
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Article ; Online: Hospitalization characteristics and outcomes of patients with cancer and COVID-19 at a comprehensive cancer center.

Manzano, Joanna-Grace M / Muthu, Mayoora / Kheder, Ed / Mohammed, Alyssa / Halm, Josiah / Dickson, Kodwo / Ali, Noman / Leung, Cerena / Koom-Dadzie, Kwame / Rubio, David / Odaro, Orhue / Sibille, Michelle / Etchegaray, Mikel / Wilson, Kaycee / Lin, Heather / George, Marina

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

2022 Volume 30, Issue 9, Page(s) 7783–7788

Abstract: Purpose: Several studies have confirmed increased mortality among patients with both COVID-19 and cancer. It remains important to continue to report observations of morbidity and mortality from COVID-19 in this vulnerable population. The purpose of this ...

Abstract	Purpose: Several studies have confirmed increased mortality among patients with both COVID-19 and cancer. It remains important to continue to report observations of morbidity and mortality from COVID-19 in this vulnerable population. The purpose of this study is to describe the hospitalization characteristics and outcomes of patients with both cancer and COVID-19 admitted to our comprehensive cancer center. Methods: This was a descriptive study of the first COVID-19-related hospitalization among adult patients with cancer admitted to our institution. Descriptive statistics were used to summarize patient demographics, clinical as well as hospitalization characteristics. Overall survival (OS) was estimated using the Kaplan-Meier method. Results: A total of 212 patients were included in our cohort with a mean age of 59 years. Fifty-four percent of patients had history of solid tumor malignancy and 46% had hematologic malignancies. Eighty-five percent of our cohort had active malignancy. The mean length of stay (LOS) for hospitalization was 11.2 days (median LOS of 6 days). Twenty-five percent had severe disease and 10.8% died during their initial hospitalization. Those who had severe disease had worse survival at the end of the observation period. Conclusions: COVID-19 among cancer patients causes significant morbidity and mortality as well as repeat hospitalizations. Continued study of COVID-19 in this vulnerable population is essential in order to better inform evolving treatment algorithms, public health policies, and infection control protocols, especially for institutions caring for patients with cancer.
MeSH term(s)	Adult ; COVID-19/therapy ; Hospitalization ; Humans ; Infection Control ; Middle Aged ; Neoplasms/epidemiology ; Neoplasms/therapy ; Retrospective Studies ; SARS-CoV-2
Language	English
Publishing date	2022-06-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1134446-5
ISSN	1433-7339 ; 0941-4355
ISSN (online)	1433-7339
ISSN	0941-4355
DOI	10.1007/s00520-022-07209-w
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Article ; Online: Readmission Patterns After GI Cancer Hospitalizations: The Medical Versus Surgical Patient.

Manzano, Joanna-Grace M / Yang, Ming / Zhao, Hui / Elting, Linda S / George, Marina C / Luo, Ruili / Suarez-Almazor, Maria E

Journal of oncology practice

2018 Volume 14, Issue 3, Page(s) e137–e148

Abstract: Purpose: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions ...

Abstract	Purpose: Readmission within 30 days has been used as a metric for quality of care received at hospitals for certain diagnoses. In the era of accountability, value-based care, and increasing cancer costs, policymakers are looking into cancer readmissions as well. It is important to describe the readmission profile of patients with cancer in the most clinically relevant approach to inform policy and health care delivery that can positively impact patient outcomes. Patients and methods: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data. We included elderly Texas residents diagnosed with GI cancer and identified risk factors for unplanned readmission using generalized estimating equations, comparing medical with surgical cancer-related hospitalizations. Results: We analyzed 69,693 hospitalizations from 31,736 patients. The unplanned readmission rate was higher after medical hospitalizations than after surgical hospitalizations (21.6% v 13.4%, respectively). Shared risk factors for readmission after medical and surgical hospitalizations included advanced disease stage, high comorbidity index, and emergency room visit and radiation therapy within 30 days before index hospitalization. Several other associated factors and reasons for readmission were noted to be unique to medical or surgical hospitalizations alone. Conclusion: Unplanned readmissions among elderly patients with GI cancer are more common after medical hospitalizations compared with surgical hospitalizations. There are shared risk factors and unique risk factors for these hospitalizations that can inform policy, health care delivery, and interventions to reduce readmissions. Other findings underscore the importance of care coordination and comorbidity management in this patient population.
MeSH term(s)	Aged ; Aged, 80 and over ; Comorbidity ; Female ; Gastrointestinal Neoplasms/diagnosis ; Gastrointestinal Neoplasms/epidemiology ; Gastrointestinal Neoplasms/therapy ; Hospitalization ; Humans ; Male ; Patient Readmission ; Quality of Health Care ; Registries ; Retrospective Studies ; Texas
Language	English
Publishing date	2018-02-13
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	2236338-5
ISSN	1935-469X ; 1554-7477
ISSN (online)	1935-469X
ISSN	1554-7477
DOI	10.1200/JOP.2017.026310
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Article ; Online: Unplanned 30-Day Readmissions in a General Internal Medicine Hospitalist Service at a Comprehensive Cancer Center.

Manzano, Joanna-Grace M / Gadiraju, Sahitya / Hiremath, Adarsh / Lin, Heather Yan / Farroni, Jeff / Halm, Josiah

Journal of oncology practice

2015 Volume 11, Issue 5, Page(s) 410–415

Abstract: Purpose: Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this ... ...

Abstract	Purpose: Hospital readmissions are considered by the Centers for Medicare and Medicaid as a metric for quality of health care delivery. Robust data on the readmission profile of patients with cancer are currently insufficient to determine whether this measure is applicable to cancer hospitals as well. To address this knowledge gap, we estimated the unplanned readmission rate and identified factors influencing unplanned readmissions in a hospitalist service at a comprehensive cancer center. Methods: We retrospectively analyzed unplanned 30-day readmission of patients discharged from the General Internal Medicine Hospitalist Service at a comprehensive cancer center between April 1, 2012, and September 30, 2012. Multiple independent variables were studied using univariable and multivariable logistic regression models, with generalized estimating equations to identify risk factors associated with readmissions. Results: We observed a readmission rate of 22.6% in our cohort. The median time to unplanned readmission was 10 days. Unplanned readmission was more likely in patients with metastatic cancer and those with three or more comorbidities. Patients discharged to hospice were less likely to be readmitted (all P values < .01). Conclusion: We observed a high unplanned readmission rate among our population of patients with cancer. The risk factors identified appear to be related to severity of illness and open up opportunities for improving coordination with primary care physicians, oncologists, and other specialists to manage comorbidities, or perhaps transition appropriate patients to palliative care. Our findings will be instrumental for developing targeted interventions to help reduce readmissions at our hospital. Our data also provide direction for appropriate application of readmission quality measures in cancer hospitals.
MeSH term(s)	Aged ; Cancer Care Facilities ; Cohort Studies ; Female ; Hospitalists/organization & administration ; Humans ; Male ; Middle Aged ; Patient Readmission/trends ; Retrospective Studies
Language	English
Publishing date	2015-09
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2236338-5
ISSN	1935-469X ; 1554-7477
ISSN (online)	1935-469X
ISSN	1554-7477
DOI	10.1200/JOP.2014.003087
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Article ; Online: Patterns and predictors of unplanned hospitalization in a population-based cohort of elderly patients with GI cancer.

Manzano, Joanna-Grace M / Luo, Ruili / Elting, Linda S / George, Marina / Suarez-Almazor, Maria E

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2014 Volume 32, Issue 31, Page(s) 3527–3533

Abstract: Purpose: Hospitalizations among patients with cancer are common and costly and, if unplanned, may interrupt oncologic treatment. The rate of unplanned hospitalizations in the population of elderly patients with cancer is unknown. We sought to describe ... ...

Abstract	Purpose: Hospitalizations among patients with cancer are common and costly and, if unplanned, may interrupt oncologic treatment. The rate of unplanned hospitalizations in the population of elderly patients with cancer is unknown. We sought to describe and quantify patterns and risk factors for early unplanned hospitalization among elderly patients with GI cancer. Patients and methods: We conducted a retrospective cohort study using linked Texas Cancer Registry and Medicare claims data from 2001 to 2009. Texas residents age 66 years or older initially diagnosed with GI cancer between 2001 and 2007 were included in the study. The unplanned hospitalization rate was estimated, and reasons for unplanned hospitalization were evaluated. Risk factors were identified using adjusted Cox proportional hazards modeling. Results: Thirty thousand one hundred ninety-nine patients were included in our study, 59% of whom had one or more unplanned hospitalizations. Of 60,837 inpatient claims, 58% were unplanned. The rate of unplanned hospitalization was 93 events per 100 person-years. The most common reasons for unplanned hospitalization were fluid and electrolyte disorders, intestinal obstruction, and pneumonia. Multivariable analysis showed that black race; residing in census tracts with poverty levels greater than 13.3%; esophageal, gastric, and pancreatic cancer; advanced disease stage; high Charlson comorbidity index score; and dual eligibility for Medicare and Medicaid increased the risk for unplanned hospitalization (all P values < .05). Conclusion: Unplanned hospitalizations among elderly patients with GI cancer are common. Some of the top reasons for unplanned hospitalization are potentially preventable, suggesting that comorbidity management and close coordination among involved health care providers should be promoted.
MeSH term(s)	Aged ; Aged, 80 and over ; Algorithms ; Comorbidity ; Demography ; Female ; Gastrointestinal Neoplasms/epidemiology ; Gastrointestinal Neoplasms/pathology ; Geriatric Assessment ; Hospitalization/statistics & numerical data ; Humans ; Length of Stay/statistics & numerical data ; Male ; Medicare ; Neoplasm Staging ; Registries ; Retrospective Studies ; Risk Factors ; Texas/epidemiology ; United States
Language	English
Publishing date	2014-10-06
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.2014.55.3131
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Zs.A 1847: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Migratory Pulmonary Infiltrates in a Patient With COVID-19 Infection and the Role of Corticosteroids.

John, Teny M / Malek, Alexandre E / Mulanovich, Victor E / Adachi, Javier A / Raad, Issam I / Hamilton, Alexis Ruth / Shpall, Elizabeth J / Rezvani, Katayoun / Aitken, Samuel L / Jain, Nitin / Klein, Kimberly / Martinez, Fernando / Jacob, Ceena N / Cherian, Sujith V / Manzano, Joanna-Grace M / Muthu, Mayoora / Wegner, Robert

Mayo Clinic proceedings

2020 Volume 95, Issue 9, Page(s) 2038–2040

MeSH term(s)	Adrenal Cortex Hormones/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/diagnostic imaging ; Coronavirus Infections/drug therapy ; Female ; Humans ; Lung/diagnostic imaging ; Lung/physiopathology ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Pneumonia, Viral/drug therapy ; SARS-CoV-2 ; Tomography, X-Ray Computed
Chemical Substances	Adrenal Cortex Hormones
Keywords	covid19
Language	English
Publishing date	2020-06-24
Publishing country	England
Document type	Case Reports ; Letter
ZDB-ID	124027-4
ISSN	1942-5546 ; 0025-6196
ISSN (online)	1942-5546
ISSN	0025-6196
DOI	10.1016/j.mayocp.2020.06.023
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Article: Migratory Pulmonary Infiltrates in a Patient With COVID-19 Infection and the Role of Corticosteroids

Mayo Clin Proc

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #612812
Database	COVID19

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