2678. Characterizing Hospitalizations and Infections Among Older Adults Receiving Palliative Chemotherapy for Hematologic Malignancies

BACKGROUND: As cancer survivorship improves, the number of patients with hematologic malignancies receiving palliative chemotherapy will grow. Older adults with hematologic malignancies often carry poor prognoses and experience high risks of infection. We evaluated the frequency of CDC criteria confirmed infection and antimicrobial use during hospitalizations following initiation of palliative chemotherapy. METHODS: We conducted a cohort study of patients aged ≥65 years who received non-curative palliative chemotherapy between January 1, 2016 and September 30, 2017 and were subsequently hospitalized by January 31, 2018. Hematologic malignancies were verified with medical record review. Infections were identified using CDC criteria, and antimicrobials were categorized by indication for use. RESULTS: We identified 268 patients receiving palliative chemotherapy for hematologic malignancies (Table 1) who had a total 591 hospitalizations (Table 2) during follow-up. There were 162 readmissions (27%) among 92 patients. Among all patients, 128 (48%) died during follow-up. Forty-one (15%) deaths were within 30 days of discharge. The most common site of death was hospice, in and outpatient (27%). Two hundred forty-nine (42%) admissions were for infectious causes; of the 34 patients who died inpatient (non hospice), 56% had been admitted for infectious causes. Antimicrobials were prescribed for prophylaxis in 57% (n = 337/591) of hospitalizations. Antimicrobials were prescribed for suspected infection in 48% (n = 282/591) of hospitalizations. Only 30% (n = 178/591) of hospitalizations had antimicrobials given for CDC confirmed infections. Figure 1 shows the most common indications for antimicrobial use. CONCLUSION: Infections are an important cause of the morbidity and mortality in older adults receiving palliative chemotherapy for hematology malignancies. Hospitalizations for infectious causes were frequent in our cohort. Nearly half of hospitalizations involved antimicrobial use for suspected infection, but CDC confirmed infections were less common. This population warrants further investigation to improve antimicrobial use. Future studies should identify the subset of patients at high risk for recurrent admissions to optimize medical care. [Image: see text] [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.