Nav: Home

Psychosocial risk factors are associated with high readmission rates, longer hospital stays

December 05, 2016

COLUMBUS, Ohio - A new study shows that psychosocial risk factors that impact a person's ability to cope with chronic stress are associated with significantly higher readmission rates and longer hospital stays among blood cancer patients undergoing hematopoietic stem cell transplantation (HSCT).

This, says, researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James), is a critical clinical concern and area of unmet need for patients who require intensive treatment to eradicate their cancer that should be addressed in a systematic way by the oncology community.

"Stem cell transplant can be a curative treatment for certain cancers, but it is a very long process that can put strains on a patient before, during and after the actual transplant," said Ashley Rosko, MD, an OSUCCC - James hematologist and senior author of the new study. "Just like we assess potential impact and risks of a patient's co-morbidities before pursuing a stem cell transplant, we saw a need to evaluate psychosocial vulnerabilities to identify those patients at the highest risk for complications and develop interventions to ensure the smoothest recovery possible."

Study Design and Results

The goal of this study was identify patients that might be at increased risk for complications during or after treatment based on non-traditional medical factors that influence overall health and wellbeing, such as depression and anxiety.

Researchers conducted an observational study of 395 patients undergoing stem cell transplant to treat acute leukemia, multiple myeloma, lymphoma and other cancers/disorders at the OSUCCC - James in Columbus, Ohio.

Stem cell transplantation involves collecting stem cells - which are produced in the bone marrow - either from the cancer patient (autologous) or a donor (allogeneic). Stem cells are then infused back into the patient after high dose chemotherapy cancer treatment is complete to help restore the bone marrow's ability to produce red and white blood cells that fight off infection.

Prior to treatment, all patients in this study had a psychosocial screening to identify factors affecting their ability to cope including: history of anxiety, depression, substance abuse, health behaviors, family social support, emotional tone, and mental status. Patients deemed at-risk were subcategorized into mild and moderate risk.

OSUCCC - James researchers found that 48 percent of all patients included in this observational study were deemed to be at risk. Psychiatric conditions (24 percent), poor health behaviors (16 percent) and poor coping history (13 percent) were the most common identified risk factors.

In addition, all patients with any degree of psychosocial vulnerability - regardless of race, disease type, remission status or type of stem cell transplant procedure - were at a higher risk for hospital readmission following HSCT and at-risk autologous transplant patients have a significantly longer length of stay.

The findings will be presented on Dec. 5, 2016, at the American Society of Hematology 2016.

"Hospital readmission in stem cell transplant patients is associated with poor overall survival, increased cost and worse quality of life so it is important that we do all that we can to identify these patients in advance of treatment to help them successfully navigate the treatment process," says Rosko. "Many of these psychosocial risk factors can be mitigated and managed to the benefit of the patient."

Researchers expect to continue this research through a prospective study aimed at identifying at-risk patients prior to therapy and offering a psychologist-led coping strategy intervention prior to treatment.

"We need to help our patients better cope with the chronic stress of a cancer diagnosis and treatment so that they are less likely to have setbacks in care due to additional illness," adds Rosko.
This research was supported as a clinical quality research initiative of The OSUCCC - James division of hematology. Co-authors of the study include first author Daniel Richardson, MD, Ying Huang, Patrick Elder, Joanna Newlin, Cyndi Kirkendall, Steven Devine, MD, Leslie Andritsos, MD, Don Benson, MD, PhD, William Blum, MD, Yvonne Efebera, MD, Craig Hofmeister, MD, Samantha Jaglowski, MD, Rebecca Klisovic, MD, Heather McGinty, PhD, Sam Penza, MD, Sumithra Vasu and Basem William, MD.

About The OSUCCC - James

The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 45 National Cancer Institute-designated Comprehensive Cancer Centers and one of only four centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs. As the cancer program's 306-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. For more information, please visit ">

Ohio State University Wexner Medical Center

Related Stem Cells Articles:

SUTD researchers create heart cells from stem cells using 3D printing
SUTD researchers 3D printed a micro-scaled physical device to demonstrate a new level of control in the directed differentiation of stem cells, enhancing the production of cardiomyocytes.
More selective elimination of leukemia stem cells and blood stem cells
Hematopoietic stem cells from a healthy donor can help patients suffering from acute leukemia.
Computer simulations visualize how DNA is recognized to convert cells into stem cells
Researchers of the Hubrecht Institute (KNAW - The Netherlands) and the Max Planck Institute in Münster (Germany) have revealed how an essential protein helps to activate genomic DNA during the conversion of regular adult human cells into stem cells.
First events in stem cells becoming specialized cells needed for organ development
Cell biologists at the University of Toronto shed light on the very first step stem cells go through to turn into the specialized cells that make up organs.
Surprising research result: All immature cells can develop into stem cells
New sensational study conducted at the University of Copenhagen disproves traditional knowledge of stem cell development.
The development of brain stem cells into new nerve cells and why this can lead to cancer
Stem cells are true Jacks-of-all-trades of our bodies, as they can turn into the many different cell types of all organs.
Healthy blood stem cells have as many DNA mutations as leukemic cells
Researchers from the Princess Máxima Center for Pediatric Oncology have shown that the number of mutations in healthy and leukemic blood stem cells does not differ.
New method grows brain cells from stem cells quickly and efficiently
Researchers at Lund University in Sweden have developed a faster method to generate functional brain cells, called astrocytes, from embryonic stem cells.
NUS researchers confine mature cells to turn them into stem cells
Recent research led by Professor G.V. Shivashankar of the Mechanobiology Institute at the National University of Singapore and the FIRC Institute of Molecular Oncology in Italy, has revealed that mature cells can be reprogrammed into re-deployable stem cells without direct genetic modification -- by confining them to a defined geometric space for an extended period of time.
Researchers develop a new method for turning skin cells into pluripotent stem cells
Researchers at the University of Helsinki, Finland, and Karolinska Institutet, Sweden, have for the first time succeeded in converting human skin cells into pluripotent stem cells by activating the cell's own genes.
More Stem Cells News and Stem Cells Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at     You can read The Transition Integrity Project's report here.