Healthcare trajectories of patients aged over 75 years after cancer surgery : an observational study on the French National Health Data System (SNDS)

Overview & Synopsis

Introduction - The healthcare trajectories of older patients with cancer remain undescribed, specifically in the field of cancer surgery. We explored, in a nationwide medico-administrative database, the healthcare trajectories of patients aged over 75 years after cancer surgery. Methods - Patients aged at least 75 years and their cancer surgery hospital stays were identified in the French National Health Data System (SNDS). A multichannel sequence analysis was carried out on a random sample of 50,000 patients to cluster the individual healthcare trajectories within one year after the index stay. A polynomial regression analysis was conducted to assess the membership determinants of each trajectory. Results – Five clusters were identified. The most prevalent trajectory (33,899 patients – 67.8%) was favorable with few deaths (one-year mortality rate of 1.6%) and hospital stays (one-year cumulative length of stay of 13 days). Age, frailty, admission from the emergency unit and malnutrition were associated with adverse healthcare pathways. Conclusion – Cancer surgery in patients aged 75 years and older is mainly associated with favorable healthcare outcomes and limited healthcare use. These findings must be detailed in posterior studies to be implemented in cancer treatment decision processes.