Cancer medicine · 2025
Association Between Discharge Medications and Oncologic Post-Embolization-Syndrome-Related Outcomes.
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Li Hanzhou, Moon John, Sim Nathan, Horný Michal, Lima Nicholas, Konstantinidis Menelaos, Iyer Deepak, Benenati Sonia, Gichoya Judy, Newsome Janice, Bercu Zachary
Аннотация
BACKGROUND: Post-embolization syndrome after transarterial chemoembolization (TACE) and Yttrium-90 radioembolization (TARE) causes significant morbidity. Understanding whether discharge prescriptions influence short-term outcomes may guide standardized pain-management strategies.
METHODS: A retrospective cohort study of 3191 patients (3988 procedures) with hepatocellular carcinoma from the Merative MarketScan Databases (2009-2022) was performed. The composite outcome was 7-day drug escalation or hospital readmission. Bivariate logistic regression identified candidate variables (p < 0.10); multivariable logistic regression with patient-clustered robust standard errors estimated adjusted odds ratios (aORs), adjusting for age, sex, and Charlson Comorbidity Index (CCI).
RESULTS: Compared to patients discharged without opioids post-chemoembolization, those prescribed opioids at discharge had 83% lower odds of experiencing drug escalation or readmission (odds ratio [aOR] = 0.17, p < 0.001), and those undergoing radioembolization had 59% lower odds (aOR = 0.41, p < 0.001). Being prescribed antiemetics or steroids was also associated with lower odds of escalation/readmission events, with percentages varying by procedure type.
CONCLUSIONS: Prescribing opioids, along with antiemetics and steroids, at discharge may reduce the likelihood of post-procedural events, such as drug escalation and readmission, in patients undergoing trans-arterial chemoembolization and radioembolization for hepatocellular carcinoma. These findings highlight the importance of a comprehensive pain management strategy in interventional oncology and warrant consideration in clinical practice guidelines.
METHODS: A retrospective cohort study of 3191 patients (3988 procedures) with hepatocellular carcinoma from the Merative MarketScan Databases (2009-2022) was performed. The composite outcome was 7-day drug escalation or hospital readmission. Bivariate logistic regression identified candidate variables (p < 0.10); multivariable logistic regression with patient-clustered robust standard errors estimated adjusted odds ratios (aORs), adjusting for age, sex, and Charlson Comorbidity Index (CCI).
RESULTS: Compared to patients discharged without opioids post-chemoembolization, those prescribed opioids at discharge had 83% lower odds of experiencing drug escalation or readmission (odds ratio [aOR] = 0.17, p < 0.001), and those undergoing radioembolization had 59% lower odds (aOR = 0.41, p < 0.001). Being prescribed antiemetics or steroids was also associated with lower odds of escalation/readmission events, with percentages varying by procedure type.
CONCLUSIONS: Prescribing opioids, along with antiemetics and steroids, at discharge may reduce the likelihood of post-procedural events, such as drug escalation and readmission, in patients undergoing trans-arterial chemoembolization and radioembolization for hepatocellular carcinoma. These findings highlight the importance of a comprehensive pain management strategy in interventional oncology and warrant consideration in clinical practice guidelines.