| Sumario: | Background & Significance: Individuals with cancer are at risk of neutropenic infections due to treatment and in some cases the cancer itself. With rural hospitals closing and cancer care moving to the outpatient setting, individuals who live far from a health care facility may encounter barriers to swift and effective treatment for neutropenic infections. Purpose: To examine socioeconomic factors that impact mortality risk for neutropenic cancer patients. Methods: A secondary data analysis was conducted using the Texas Hospital Inpatient Discharge data from the Texas Hospital Discharge Data Public Use Data File (PUDF) for the years 2016 to 2023. Descriptive statistics and chi-square were used to evaluate the distribution of cancer cases with infection by rurality, poverty, and mortality risk. Ordinal logistic regression analysis evaluated odds of mortality risk. Findings and Interpretations: A total of 702,372 admissions of individuals with cancer who were admitted with neutropenia or sepsis were examined. Most patients were 65 years or older (52.17%), predominantly female (48.6%), Non-Hispanic White (52.1%) and from urban areas (88.27%). Most presented with major illness severity (45%), major risk of mortality (40.1%) and required intensive/critical care (46.8%). Rural areas accounted for disproportionately older patients, Non-Hispanic Whites, higher poverty, and were more likely to require transfer to another facility. In our model, adults aged 65 and older had the highest odds for mortality risk (OR = 5.25, 95% CI [5.09, 5.41]) and Non-Hispanic Blacks also had higher odds (OR = 1.16, 95% CI [1.14, 1.17]). Patients admitted from home (OR = 2.25, 95% CI [2.22, 2.29]) or admitted from other health care facilities (OR = 2.27, 95% CI [2.16, 2.37]) or transferred from another facility (OR = 2.02, 95% CI [1.98, 2.06]) had higher odds than those who were admitted directly from clinics. As expected, an increased length of stay (more than 12 days) led to increased odds (OR = 3.73, 95% CI [3.68, 3.79]). Rurality alone did not increase odds for mortality risk (OR = 1.01, 95% CI [1.00, 1.03]). Discussion: These findings reinforce the need for health care professionals to continuously reinforce education about the importance of seeking treatment when a patient has signs/symptoms of infection. This is especially true for patients who will be going home or live farther from hospitals. Early identification of infection can reduce severity of illness and mortality risk.
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