B128
Differences in hospital admission patterns between attenders and non-attenders at a paediatric long-term follow-up clinic in Yorkshire, UK
Richard Feltbower1, Rebecca Birch1, Dan Stark2, Ian Lewis2, Michelle Kwok-Williams2, Rob Murray2, Adam Glaser2
1University of Leeds, UK, 2Leeds Teaching Hospitals NHS Trust, Leeds, UK
Aim
Little information exists comparing patient outcomes between individuals who attend paediatric long-term follow-up (LTFU) clinics and those who do not. We aimed to examine survival and hospital activity among a cohort of young people, comparing differences between attenders and non-attenders at a LTFU clinic.
Method
Individuals were identified using the Yorkshire Specialist Register of Cancer in Children and Young People. Eligible subjects were those at least five years off-treatment from April 2000 onwards who were diagnosed aged under 18 years. Patients attending the LTFU clinic in Leeds at least once from April 2000 onwards were flagged and linked to the Yorkshire Register. Hospital admissions were linked to the Register through an extract of hospital episode statistics data. Hospital admissions occurring five years after treatment were compared between LTFU attenders and non-attenders by tumour type. Survival rates between attenders and non-attenders were calculated using Kaplan-Meier estimation.
Results
861 long-term survivors were identified from the Register, of whom 435 (51%) attended the LTFU clinic. 29% of these survivors were diagnosed with leukaemia, 15% with lymphoma, 22% with a CNS tumour and 35% with other solid tumours. The proportion attending LTFU varied by diagnostic group, ranging from 55-60% for leukaemia/lymphoma, 70-80% for neuroblastoma, renal, and hepatic tumours, and 10-25% for CNS and germ cell tumours. Leukaemia (27%), lymphoma (8%) and CNS tumours (34%) accounted for two-thirds of all HES admissions (n=948). The mean number of admissions per patient was the same for LTFU attenders (n=1.2) compared to non-attenders (n=1.0). This pattern was similar across most diagnostic groups apart from CNS tumours (2.4 vs 1.5) and bone tumours (6.7 vs 0.1). No significant difference in survival was observed between attenders and non-attenders (logrank test p=0.27).
Conclusion
Our data indicate substantial variation in the proportion of patients who attend a paediatric LTFU clinic by diagnostic group. We found no difference in survival or hospital admission rates between attenders and non-attenders of the LTFU clinic. Future work will focus on reasons for admission.
