{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:18:00Z","timestamp":1785831480917,"version":"3.56.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007184","name":"Yale School of Medicine","doi-asserted-by":"publisher","award":["2T32AI007517-16"],"award-info":[{"award-number":["2T32AI007517-16"]}],"id":[{"id":"10.13039\/100007184","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Antibiotic use may increase hospital length of stay (LOS) among older patients with advanced cancer who are transitioned to comfort measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We studied a cohort of patients with advanced cancer aged \u226565 years who were transitioned to comfort measures during admission from July 1, 2014, through November 30, 2016. We evaluated the association between antibiotic exposure and LOS using a Poisson regression model adjusted for age, gender, cancer type, comorbidities, infection, and intensive care unit admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 461 patients with advanced cancer, median age was 74 years (range: 65-99), 49.0% (n = 226) were female, and 20.6% (n = 95) had liquid tumors. Overall, 82.9% (n = 382) received \u22651 antibiotic and 64.6% (n = 298) had \u22651 infection diagnosis during hospitalization. Infection diagnoses commonly included sepsis (35%, n = 161\/461), pneumonia (25%, n = 117\/461), and urinary tract infection (14%, n = 66\/461). Among those receiving antibiotics, the most common choices included vancomycin (79%, n = 300\/382), cephalosporins (63%, n = 241\/382), and penicillins (45%, n = 172\/382). In a multivariable Poisson regression model, LOS was 34% longer (count ratio = 1.34, [95% confidence interval: 1.20-1.51]) among those exposed versus unexposed to antibiotics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Antibiotic use among patients with advanced cancer who are transitioned to comfort measures is associated with longer LOS. These data illustrate the importance of tradeoffs associated with antibiotic use, such as unintended increased LOS, when striving for goal-concordant care near the end of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1049909119855617","type":"journal-article","created":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T21:44:36Z","timestamp":1560289476000},"page":"27-33","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Increased Length of Stay Associated With Antibiotic Use in Older Adults With Advanced Cancer Transitioned to Comfort Measures"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2281-7508","authenticated-orcid":false,"given":"Rupak","family":"Datta","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mojun","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather","family":"Allore","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Quagliarello","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manisha","family":"Juthani-Mehta","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, CT, USA"},{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 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