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Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer

BACKGROUND: Nutritional status is related to treatment outcomes for esophageal cancer. Residing in a food desert (FD) has been associated with worse outcomes in breast and colon cancer. We assessed the association of residing in a FD on 30-day outcomes of esophageal cancer patients who received tri-...

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Autores principales: Fay, Kayla A., Maeder, Matthew E., Emond, Jennifer A., Hasson, Rian M., Millington, Timothy M., Finley, David J., Phillips, Joseph D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264063/
https://www.ncbi.nlm.nih.gov/pubmed/35813712
http://dx.doi.org/10.21037/jtd-21-1637
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author Fay, Kayla A.
Maeder, Matthew E.
Emond, Jennifer A.
Hasson, Rian M.
Millington, Timothy M.
Finley, David J.
Phillips, Joseph D.
author_facet Fay, Kayla A.
Maeder, Matthew E.
Emond, Jennifer A.
Hasson, Rian M.
Millington, Timothy M.
Finley, David J.
Phillips, Joseph D.
author_sort Fay, Kayla A.
collection PubMed
description BACKGROUND: Nutritional status is related to treatment outcomes for esophageal cancer. Residing in a food desert (FD) has been associated with worse outcomes in breast and colon cancer. We assessed the association of residing in a FD on 30-day outcomes of esophageal cancer patients who received tri-modality therapy. METHODS: A retrospective review of patients who underwent esophagectomy (1/2015 to 7/2020, in New Hampshire, USA) was performed. Patients were excluded if they did not undergo neo-adjuvant treatment, required treatment outside of standard Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) protocol, or lacked both pre and post neo-adjuvant treatment computed tomography (CT) scans for review. Demographics, nutrition parameters, treatment characteristics, 30-day complications and 90-day mortality were reviewed. FD status was defined by the United States Department of Agriculture (USDA) Food Access Research Atlas and cross-referenced with patients’ home zip code. Readmission was defined as readmission to any hospital for any reason within 30-day of discharge. Univariable analysis was conducted using Student’s t-test or Wilcoxon rank-sum for continuous variables, and Fisher’s exact test for categorical variables. Multivariable logistic regression was then used to model readmission status on FD status adjusted for measures statistically associated with readmission status at the P<0.10 in univariable analyses. RESULTS: Seventy-eight patients were included in the analysis. Overall pre-treatment prevalence of sarcopenia was 11.5% (9/78) and did not vary by FD status. Univariable analysis, demonstrated few significant differences between those who were readmitted and those who were not. On unadjusted analysis, patients who lived in a FD were 5 times more likely to be readmitted [5.16; 95% confidence interval (CI): 1.70–15.67] compared to those who did not. Residing in a FD remained a significant risk factor for readmission after adjustment for operative time, discharge to a rehabilitation facility and development of a grade III/IV complication [adjusted odds ratio (OR): 6.38; 95% CI: 1.45–28.08]. CONCLUSIONS: Our data suggest that residing in a FD is a prognostic factor for readmission after tri-modality therapy for esophageal cancer. Clinicians need to be aware that previously established nutritional markers may not completely capture nutritional status and living in a FD may significantly increase the risk of readmission in these patients.
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spelling pubmed-92640632022-07-09 Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer Fay, Kayla A. Maeder, Matthew E. Emond, Jennifer A. Hasson, Rian M. Millington, Timothy M. Finley, David J. Phillips, Joseph D. J Thorac Dis Original Article BACKGROUND: Nutritional status is related to treatment outcomes for esophageal cancer. Residing in a food desert (FD) has been associated with worse outcomes in breast and colon cancer. We assessed the association of residing in a FD on 30-day outcomes of esophageal cancer patients who received tri-modality therapy. METHODS: A retrospective review of patients who underwent esophagectomy (1/2015 to 7/2020, in New Hampshire, USA) was performed. Patients were excluded if they did not undergo neo-adjuvant treatment, required treatment outside of standard Chemoradiotherapy for Oesophageal Cancer Followed by Surgery Study (CROSS) protocol, or lacked both pre and post neo-adjuvant treatment computed tomography (CT) scans for review. Demographics, nutrition parameters, treatment characteristics, 30-day complications and 90-day mortality were reviewed. FD status was defined by the United States Department of Agriculture (USDA) Food Access Research Atlas and cross-referenced with patients’ home zip code. Readmission was defined as readmission to any hospital for any reason within 30-day of discharge. Univariable analysis was conducted using Student’s t-test or Wilcoxon rank-sum for continuous variables, and Fisher’s exact test for categorical variables. Multivariable logistic regression was then used to model readmission status on FD status adjusted for measures statistically associated with readmission status at the P<0.10 in univariable analyses. RESULTS: Seventy-eight patients were included in the analysis. Overall pre-treatment prevalence of sarcopenia was 11.5% (9/78) and did not vary by FD status. Univariable analysis, demonstrated few significant differences between those who were readmitted and those who were not. On unadjusted analysis, patients who lived in a FD were 5 times more likely to be readmitted [5.16; 95% confidence interval (CI): 1.70–15.67] compared to those who did not. Residing in a FD remained a significant risk factor for readmission after adjustment for operative time, discharge to a rehabilitation facility and development of a grade III/IV complication [adjusted odds ratio (OR): 6.38; 95% CI: 1.45–28.08]. CONCLUSIONS: Our data suggest that residing in a FD is a prognostic factor for readmission after tri-modality therapy for esophageal cancer. Clinicians need to be aware that previously established nutritional markers may not completely capture nutritional status and living in a FD may significantly increase the risk of readmission in these patients. AME Publishing Company 2022-06 /pmc/articles/PMC9264063/ /pubmed/35813712 http://dx.doi.org/10.21037/jtd-21-1637 Text en 2022 Journal of Thoracic Disease. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Fay, Kayla A.
Maeder, Matthew E.
Emond, Jennifer A.
Hasson, Rian M.
Millington, Timothy M.
Finley, David J.
Phillips, Joseph D.
Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title_full Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title_fullStr Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title_full_unstemmed Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title_short Residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
title_sort residing in a food desert is associated with an increased risk of readmission following esophagectomy for cancer
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9264063/
https://www.ncbi.nlm.nih.gov/pubmed/35813712
http://dx.doi.org/10.21037/jtd-21-1637
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