Browsing by Author "Osazuwa-Peters, Nosayaba"
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Item Embargo Chronic Pain and Depression among Cancer Survivors(2024) Chen, MengBackground: Chronic pain is a highly prevalent and disabling concern among the 18 million cancer survivors in the United States, yet it is understudied. This study aimed to assess the time trends and related risk factors of chronic pain among cancer survivors. Methods: Using data from the National Health Interview Survey (NHIS), we included adult US cancer survivors from 2010 to 2021. Chronic pain was the outcome of interest, defined as pain on most days or every day during the past 3 months. Joinpoint regression models estimated annual percentage changes (APC) of chronic pain prevalence and multivariable logistic regression models estimated odds of experiencing chronic pain across different subgroups. Results: The final study sample included 377,509 respondents, with 39,473 (10.5%) reporting a history of cancer. Reported chronic pain prevalence decreased from 2016 among both cancer survivors (APC = -7.38%, 95% CI: -35.16%, 32.30%) and non-cancer individuals (APC = -4.71%, 95% CI: -12.34%, 3.59%). Compared to non-cancer individuals, cancer survivors had 20% higher odds of experiencing chronic pain (aOR = 1.20, 95% CI: 1.14, 1.27). Among cancer survivors, those with moderate depression had 40% higher odds of experiencing chronic pain (aOR = 1.40, 95% CI: 1.29, 1.52), while those with severe depression had 166% higher odds (aOR = 2.66, 95% CI: 2.34, 3.02), compared to those without depression. Conclusions: The association between chronic pain and depression calls for more targeted interventions or strategies towards pain management for cancer survivors to improve their life of quality and enhance overall survivorship.
Item Open Access Head and neck cancer mortality in the United States: Regional differences in hospice use and place of death(BJC Reports) White, Melissa C; Canick, Julia E; Omer, Tariq M; Barnes, Justin M; Reed, William T; Rohde, Rebecca L; Abouelella, Dina K; Boakye, Eric Adjei; Ramos, Katherine; Kahmke, Russel R; Osazuwa-Peters, NosayabaItem Open Access Malnutrition and Adverse Outcomes After Surgery for Head and Neck Cancer.(JAMA otolaryngology-- head & neck surgery, 2023-10) Reed, William T; Jiang, Rong; Ohnuma, Tetsu; Kahmke, Russel R; Pyati, Shreyas; Krishnamoorthy, Vijay; Raghunathan, Karthik; Osazuwa-Peters, NosayabaImportance
Patients with head and neck cancer (HNC) have an increased risk of malnutrition, partly due to disease location and treatment sequelae. Although malnutrition is associated with adverse outcomes, there is little data on the extent of outcomes and the sociodemographic factors associated with malnutrition in patients with HNC.Objectives
To investigate the association of race, ethnicity, and payer type with perioperative malnutrition in patients undergoing HNC surgery and how malnutrition affects clinical outcomes.Design, setting, and participants
This retrospective cohort study used data from the Premier Healthcare Database to assess adult patients who had undergone HNC surgery from January 2008 to June 2020 at 482 hospitals across the US. Diagnosis and procedure codes were used to identify a subset of patients with perioperative malnutrition. Patient characteristics, payer types, and hospital outcomes were then compared to find associations among race, ethnicity, payer type, malnutrition, and clinical outcomes using multivariable logistic regression models. Analyses were performed from August 2022 to January 2023.Exposure(s)
Race, ethnicity, and payer type for primary outcome, and perioperative malnutrition status, race, ethnicity, and payer type for secondary outcomes.Main outcome(s) and measure(s)
Perioperative malnutrition status. Secondary outcomes were discharge to home after surgery, hospital length of stay (LOS), total cost, and postoperative pulmonary complications (PPCs).Results
The study population comprised 13 895 adult patients who had undergone HNC surgery during the study period; they had a mean (SD) age of 63.4 (12.1) years; 9425 male (67.8%) patients; 968 Black (7.0%), 10 698 White (77.0%), and 2229 (16.0%) individuals of other races; and 887 Hispanic (6.4%) and 13 008 non-Hispanic (93.6%) individuals. Among the total sample, there were 3136 patients (22.6%) diagnosed with perioperative malnutrition. Compared with White patients and patients with private health insurance, the odds of malnutrition were higher for non-Hispanic Black patients (adjusted odds ratio [aOR], 1.31; 95% CI, 1.11-1.56), Medicaid-insured patients (aOR, 1.68; 95% CI, 1.46-1.95), and Medicare-insured patients (aOR, 1.24; 95% CI, 1.10-1.73). Black patients and patients insured by Medicaid had increased LOS, costs, and PPCs, and lower rates of discharge to home. Malnutrition was independently associated with increased LOS (β, 5.20 additional days; 95% CI, 4.83-5.64), higher costs (β, $15 722 more cost; 95% CI, $14 301-$17 143), increased odds of PPCs (aOR, 2.04; 95% CI, 1.83-2.23), and lower odds of discharge to home (aOR, 0.34; 95% CI, 0.31-0.38). No independent association between malnutrition and mortality was observed.Conclusions and relevance
This retrospective cohort study found that 1 in 5 patients undergoing HNC surgery were malnourished. Malnourishment disproportionately affected Black patients and patients with Medicaid, and contributed to longer hospital stays, higher costs, and more postoperative complications.