Clinical Characteristics and Management of Patients Admitted to the Supportive Care Clinic and Predisposing Factors of Unplanned Hospital Readmission: Single-Center Experience.

It is well known that supportive care clinics are vital in medical oncology practice. This study aims to present a portrait of the supportive care clinic of a tertiary cancer center in a low-middle-income country. This study included patients admitted to our supportive care clinic between January 2019 and December 2023. This study included patients who attended the supportive care clinic. For patients who were readmitted more than once throughout the study period, only the first readmission was included in the analysis. The primary outcome of this study was a better understanding of the risk factors associated with hospital readmissions in cancer patients, which could lead to improved patient outcomes. In addition, the secondary objective was to identify the characteristics of patients and clinical decisions regarding follow-ups as inpatients or outpatients referred to the supportive care clinic. This study included 477 patients; 300 (62.9%) were directed to oncology inpatient care, while 177 (37.1%) were treated as outpatients. The most common diagnoses were lung cancer (20.5%), colorectal cancer (13.6%), and breast cancer (8.4%). Most patients (71.5%) were evaluated for symptom palliation. In multivariate analysis, metastatic disease (OR: 2.52 95% CI 1.48-4.29 = 0.001), Eastern Cooperative Oncology Group (ECOG) performance status (OR: 1.58 95% CI 1.04-2.42 = 0.034), and a decrease in albumin levels (OR: 0.42 95% CI 0.29-0.61 < 0.001) were significantly related to hospitalization. In univariate analyses, albumin level ( < 0.001), disease stage ( = 0.007), and ECOG performance status ( = 0.025) were statistically associated with unplanned hospital readmission. Among these factors, a decrease in albumin levels was significantly associated with the outcome, with an odds ratio of 0.54 (95% CI 0.39-0.75, < 0.001), indicating a protective effect of higher albumin levels. In univariate analyses, sex ( = 0.016), cancer treatment type ( = 0.010), albumin level ( < 0.001), disease stage ( < 0.001), unplanned hospital readmission ( < 0.001), ECOG performance status ( < 0.001), and hemoglobin ( = 0.008) were statistically related to overall survival. Among these factors, sex (HR: 1.28 95% CI 1.03-1.59 = 0.025), a decrease in albumin levels (HR: 0.67 95% CI 0.56-0.82 < 0.001), disease stage (HR: 1.52 95% CI 1.11-2.09 = 0.008), unplanned hospital readmission (HR: 1.30 95% CI 1.03-1.63 = 0.027), and ECOG performance status (HR: 3.45 95% CI 2.68-4.45 < 0.001) remained significant in the multivariate analysis. This study shows that supportive care clinics are a key element of patient care. Early evaluation of patients in supportive care clinics may aid clinicians in identifying high-risk patients who may require closer follow-up or inpatient care. Several factors were identified as predisposing to hospitalization, unplanned hospital readmission, and overall survival. Further prospective studies are needed to determine the risk factors associated with hospitalization, readmission, and overall survival.