Patient-reported global health to predict adverse health outcomes in an expanded cohort of patients with advanced sarcoma.
Authors: Chitnis Saurabh , Husain Marium , Pracha Nooruddin , Hussein Ahmed , Xu Menglin , Chen James Lin , Liebner David A. , Tinoco Gabriel 
Published: June 2024

11579

Background: The rarity of sarcoma cancers and the debilitating effects of chemotherapy often lead to challenges in the quality of life for these patients. Uncontrolled symptoms can cause unplanned hospital admissions and emergency room visits that delay treatment regimens and negatively impact patient outcomes. To assess patients' physical and mental well-being during treatment, we used validated tools like the PROMIS Global Health v1.2 (PROMIS-10) surveys. We sought to expand our cohort of patients with advanced sarcoma to better understand and establish the relationship between PROMIS-10 scores and adverse outcomes of interest, including unplanned admissions/ER visits and patient mortality. This is one of the largest quality of life assessments published for patients with sarcoma. Methods: All patients seen in the Sarcoma Clinics at The Ohio State University routinely complete the PROMIS-10 survey at each clinic visit. For this expanded cohort, we collected the raw and normalized t-scores for PROMIS-10 surveys for all patients consented to The Ohio State University Sarcoma Registry (OSU-14242) from 2/1/2020 to 12/31/2022. We also collected data on unplanned hospital admission/ED visits and mortality data for each patient. Results: A total of 1598 surveys for 332 patients were collected for the study period. Our prior cohort was 112 patients. Most patients were female (54%), and the median age was 58 years. Seventy-two of 332 patients experienced an unplanned admission or ED visit during the study, with a total of 137 such encounters during the study period. Physical and Mental PROMIS-10 scores were significantly associated with an unplanned admission or ED visit (p <0.001), a stronger correlation compared to our initial cohort, where we did not find a correlation with Mental PROMIS-10 scores. Physical and Mental PROMIS10 scores were independently analyzed as they were highly collinear. A total of 82 patients died during the study period. There was no association found between PROMIS-10 scores and mortality in a mixed model; however, bivariate associations did reveal that patients who had died had reported lower Physical and Mental PROMIS-10 scores. We had previously seen a signal that female patients had higher mortality rates, but with a larger sample size, there was no correlation between female gender or age with unplanned hospital admission/ED visits and mortality. Conclusions: Our research consistently shows that obtaining patient-reported outcomes during treatment is essential to accurately evaluate patients' physical and mental well-being. We are currently performing an additional confirmatory analysis of the predictive value of the PROMIS-10 survey for adverse events and treatment-related complications with a larger sample size. This data is paramount in developing more effective interventions to significantly improve patients’ quality of life.