Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia
Abstract Background Childhood cancer survivors (CCS) experience an elevated burden of health complications, underscoring the importance of understanding the patterns of multimorbidity to guide the management of survivors with complex medical needs. Methods We examined the patterns of hospitalisation...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-03-01
|
| Series: | BJC Reports |
| Online Access: | https://doi.org/10.1038/s44276-024-00114-1 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850039830451322880 |
|---|---|
| author | Tasnim Abdalla Jeneva L. Ohan Angela Ives Daniel White Catherine S. Choong Max Bulsara Jason D. Pole |
| author_facet | Tasnim Abdalla Jeneva L. Ohan Angela Ives Daniel White Catherine S. Choong Max Bulsara Jason D. Pole |
| author_sort | Tasnim Abdalla |
| collection | DOAJ |
| description | Abstract Background Childhood cancer survivors (CCS) experience an elevated burden of health complications, underscoring the importance of understanding the patterns of multimorbidity to guide the management of survivors with complex medical needs. Methods We examined the patterns of hospitalisations with multimorbidity in 5-year CCS (n = 2938) and age- and sex-matched non-cancer comparisons (n = 24,792) using statewide records of inpatient admissions in Western Australia from 1987 to 2019. Results Multimorbidity rates were higher for CCS (10.6, 95%CI 10.2–10.9) than for non-cancer comparisons (3.2, 95%CI 3.2–3.3). CCS exhibited a significantly higher adjusted hazard ratio of multimorbidity, particularly when admitted for neoplasms (14.6, 95%CI 11.2–19.1), as well as blood (7.3, 95%CI 4.9–10.7), neurological and sensory (5.2, 95%CI 4.2–6.6), and cardiovascular (3.6, 95%CI 2.6–4.8) diseases. By the age of 55 years, chronic multimorbidity was more prevalent in survivors than in comparisons (14.5% vs. 5.3%). Psychiatric disorders were common comorbidities, particularly in those admitted for neurological and sensory (71.1%), endocrine (61.5%), and digestive (59.3%) diseases. Multimorbidity during hospitalisation increased the length of hospital stay (p < 0.05). Key condition clusters included (1) psychoactive substance dependence, alcohol misuse, and other mental disorders; (2) hypertension, diabetes, kidney disease, and musculoskeletal diseases; (3) epilepsy, hypothyroidism, and other liver diseases; and (4) hypertension, kidney disease, and other liver diseases. Conclusions These findings suggest that exposure to cancer in childhood elevates the risk of multimorbidity. The reconfiguration of healthcare delivery to enhance personalised care and clinical integration is essential for effectively managing multimorbidity in this population. |
| format | Article |
| id | doaj-art-d12dfdc020184ba896d9a03639b36d20 |
| institution | DOAJ |
| issn | 2731-9377 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | BJC Reports |
| spelling | doaj-art-d12dfdc020184ba896d9a03639b36d202025-08-20T02:56:12ZengNature PortfolioBJC Reports2731-93772025-03-013111110.1038/s44276-024-00114-1Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western AustraliaTasnim Abdalla0Jeneva L. Ohan1Angela Ives2Daniel White3Catherine S. Choong4Max Bulsara5Jason D. Pole6Faculty of Health and Medical Sciences, The University of Western AustraliaSchool of Psychological Science, The University of Western AustraliaMedical School, The University of Western AustraliaHaematology Department, Women’s and Children’s HospitalMedical School, The University of Western AustraliaInstitute for Health Research, The University of Notre Dame AustraliaCentre for Health Services Research, The University of QueenslandAbstract Background Childhood cancer survivors (CCS) experience an elevated burden of health complications, underscoring the importance of understanding the patterns of multimorbidity to guide the management of survivors with complex medical needs. Methods We examined the patterns of hospitalisations with multimorbidity in 5-year CCS (n = 2938) and age- and sex-matched non-cancer comparisons (n = 24,792) using statewide records of inpatient admissions in Western Australia from 1987 to 2019. Results Multimorbidity rates were higher for CCS (10.6, 95%CI 10.2–10.9) than for non-cancer comparisons (3.2, 95%CI 3.2–3.3). CCS exhibited a significantly higher adjusted hazard ratio of multimorbidity, particularly when admitted for neoplasms (14.6, 95%CI 11.2–19.1), as well as blood (7.3, 95%CI 4.9–10.7), neurological and sensory (5.2, 95%CI 4.2–6.6), and cardiovascular (3.6, 95%CI 2.6–4.8) diseases. By the age of 55 years, chronic multimorbidity was more prevalent in survivors than in comparisons (14.5% vs. 5.3%). Psychiatric disorders were common comorbidities, particularly in those admitted for neurological and sensory (71.1%), endocrine (61.5%), and digestive (59.3%) diseases. Multimorbidity during hospitalisation increased the length of hospital stay (p < 0.05). Key condition clusters included (1) psychoactive substance dependence, alcohol misuse, and other mental disorders; (2) hypertension, diabetes, kidney disease, and musculoskeletal diseases; (3) epilepsy, hypothyroidism, and other liver diseases; and (4) hypertension, kidney disease, and other liver diseases. Conclusions These findings suggest that exposure to cancer in childhood elevates the risk of multimorbidity. The reconfiguration of healthcare delivery to enhance personalised care and clinical integration is essential for effectively managing multimorbidity in this population.https://doi.org/10.1038/s44276-024-00114-1 |
| spellingShingle | Tasnim Abdalla Jeneva L. Ohan Angela Ives Daniel White Catherine S. Choong Max Bulsara Jason D. Pole Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia BJC Reports |
| title | Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia |
| title_full | Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia |
| title_fullStr | Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia |
| title_full_unstemmed | Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia |
| title_short | Epidemiology of multimorbidity in childhood cancer survivors: a matched cohort study of inpatient hospitalisations in Western Australia |
| title_sort | epidemiology of multimorbidity in childhood cancer survivors a matched cohort study of inpatient hospitalisations in western australia |
| url | https://doi.org/10.1038/s44276-024-00114-1 |
| work_keys_str_mv | AT tasnimabdalla epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT jenevalohan epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT angelaives epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT danielwhite epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT catherineschoong epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT maxbulsara epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia AT jasondpole epidemiologyofmultimorbidityinchildhoodcancersurvivorsamatchedcohortstudyofinpatienthospitalisationsinwesternaustralia |