Authors: Jon X Wang, Lauren Boreta, Emily Yee, Steve E. Braunstein, Julian C. Hong
Published: 2020-10-08
DOI: 10.1200/jco.2020.38.29_suppl.27
Source: Full article
27 Background: Delayed inpatient radiotherapy (RT) consultation can result in delayed treatment, extended hospitalization, and increased costs. There are limited data characterizing populations that may have longer time-to-consult (TTC). Methods: A single institutional electronic health record deidentified corporate data warehouse was used to identify adult inpatients with a consultation to radiation oncology between 2014-2019. TTC was defined as time from admission to placement of consultation. Multivariate linear regression was used to examine adjusted associations for factors including age, diagnosis, admission date, admitting service, and patient-reported sex, race and ethnicity to TTC. Continuous variables were normalized to generate standardized beta coefficients (B). Results: A total of 856 admissions with radiation oncology consult were identified. Median TTC was 21 hours (interquartile range [IQR] 5-69). Median age was 61 (IQR 49-68) and 51% of patients were male. Most patients were white (58%) and non-Hispanic or Latino (80%). The most common admission primary diagnoses were brain metastasis (14%), bone metastasis (10%), and primary brain neoplasm (9%), Most common admitting services were Neurosurgery (49%), Hospital Medicine (22%), Malignant Hematology (8%), and Gynecologic Oncology (8%). Primary brain neoplasms (vs brain metastases B = 64; P < .001), other non-metastatic diagnoses (vs brain metastases B = 45; P < .001) and admission on the malignant hematology service (vs neurosurgery; B = 37; P = .03) were associated with longer TTC. Patient demographic characteristics (age sex, race, ethnicity), and admission date did not have significant associations with TTC. Longer TTC was correlated with longer hospitalization (Pearson’s corr = 0.48). Conclusions: No clear demographic disparities in inpatient RT consultation were identified. Certain diagnoses and services were associated with longer TTC, potentially related to clinical practice. Increased TTC was associated with longer hospital length of stay.