{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:30:50Z","timestamp":1787923850045,"version":"build-2784847793"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008809","name":"University of Hail","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"\n Background<\/jats:title>\n Oncology inpatients face physiological decline alongside complex pharmacology, yet clinical mortality predictors and drug-related risks remain understudied in Middle Eastern populations. This study identified independent predictors of in-hospital mortality and characterized potential drug\u2013drug interactions (pDDIs) among hospitalized cancer patients in Saudi Arabia.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This retrospective cohort study evaluated 401 adult oncology inpatients admitted to a tertiary care center in Hail, Saudi Arabia (2020\u20132022). Demographics, clinical parameters, and medication profiles were extracted from medical records. Bivariate correlations were assessed using point-biserial (\n \n \n \n \n r<\/mml:mi>\n \n p<\/mml:mi>\n b<\/mml:mi>\n <\/mml:mrow>\n <\/mml:msub>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ) and phi (\n \n \n \n \u03d5<\/mml:mi>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ) coefficients. Independent mortality predictors were identified via multivariable binary logistic regression, and biomarker discrimination was evaluated using receiver operating characteristic (ROC) curves. Potential DDIs were screened using\n Drugs.com<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The cohort was predominantly female (67.6%) and Saudi (85.0%), with solid malignancies accounting for 94.3% of cases. In-hospital mortality was 25.2% (\n \n \n \n n<\/mml:mi>\n =<\/mml:mo>\n 101<\/mml:mn>\n \/<\/mml:mo>\n 401<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ). Bivariate correlations demonstrated significant associations with mortality across clinical parameters, including mechanical ventilation requirements (\n \n \n \n \u03d5<\/mml:mi>\n =<\/mml:mo>\n 0.118<\/mml:mn>\n ,<\/mml:mo>\n p<\/mml:mi>\n =<\/mml:mo>\n 0.018<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ). Multivariable regression identified four independent physiological predictors of mortality: renal failure (\n \n \n \n aOR<\/mml:mtext>\n =<\/mml:mo>\n 44.29<\/mml:mn>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n \u00a0CI<\/mml:mtext>\n :<\/mml:mo>\n 1.07<\/mml:mn>\n \u2212<\/mml:mo>\n 1836.31<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ), baseline albumin\n \n \n \n \n \n \n aOR<\/mml:mtext>\n =<\/mml:mo>\n 0.71<\/mml:mn>\n \u00a0per\u00a0<\/mml:mtext>\n g<\/mml:mi>\n \/<\/mml:mo>\n L<\/mml:mi>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n \u00a0CI<\/mml:mtext>\n :<\/mml:mo>\n 0.55<\/mml:mn>\n \u2212<\/mml:mo>\n 0.91<\/mml:mn>\n <\/mml:mrow>\n <\/mml:mrow>\n <\/mml:mfenced>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n , serum creatinine (\n \n \n \n aOR<\/mml:mtext>\n =<\/mml:mo>\n 1.02<\/mml:mn>\n \u00a0per\u00a0<\/mml:mtext>\n \u03bc<\/mml:mi>\n mol<\/mml:mtext>\n \/<\/mml:mo>\n L<\/mml:mi>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n \u00a0CI<\/mml:mtext>\n :<\/mml:mo>\n 1.001<\/mml:mn>\n \u2212<\/mml:mo>\n 1.04<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ), and oxygen saturation (\n \n \n \n aOR<\/mml:mtext>\n =<\/mml:mo>\n 0.68<\/mml:mn>\n \u00a0per\u00a0<\/mml:mtext>\n %<\/mml:mo>\n ,<\/mml:mo>\n 95<\/mml:mn>\n %<\/mml:mo>\n \u00a0CI<\/mml:mtext>\n :<\/mml:mo>\n 0.50<\/mml:mn>\n \u2212<\/mml:mo>\n 0.93<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ). Serum albumin showed high individual discrimination (\n \n \n \n AUC<\/mml:mtext>\n =<\/mml:mo>\n 0.920<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n ), while the combined multivariable model achieved an\n \n \n AUC<\/mml:mtext>\n <\/mml:math>\n <\/jats:inline-formula>\n of 0.953. Pharmacological screening revealed near-universal interaction prevalence: 98.6% of 2,148 prescriptions contained a pDDI flag (54.9% severe), and 96.5% of patients had\n \n \n \n \u2265<\/mml:mo>\n 1<\/mml:mn>\n <\/mml:mrow>\n <\/mml:math>\n <\/jats:inline-formula>\n severe pDDI flag.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n In-hospital mortality is strongly driven by acute organ dysfunction and physiological decline rather than database-flagged interactions alone. However, the high prevalence of severe pDDI flags highlights a critical need to integrate structured clinical pharmacy reviews into oncology admission protocols. Targeted medication safety interventions should focus on avoiding nephrotoxic combinations and establishing pre-therapeutic pharmacogenetic screening to mitigate potential iatrogenic risks.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fphar.2026.1825631","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:50:38Z","timestamp":1787921438000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, laboratory, and medication-related factors associated with in-hospital mortality among oncology patients at a tertiary hospital in Saudi Arabia"],"prefix":"10.3389","volume":"17","author":[{"given":"Ahmed","family":"Alafnan","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meshal M.","family":"Alorainan","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanad M.","family":"Alanazi","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salman F.","family":"Algharbi","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal R.","family":"Alshammari","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammar","family":"Alghaslan","sequence":"additional","affiliation":[{"name":"College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hammad","family":"Saleem","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Sciences (IPS), University of Veterinary and Animal Sciences (UVAS)","place":["Lahore, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleh","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, Faculty of Pharmacy, Al-Baha University","place":["Al-Baha, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Farooq","family":"Shaikh","sequence":"additional","affiliation":[{"name":"School of Dentistry and Medical Sciences, Charles Sturt University, Orange","place":["NSW, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sirajudheen","family":"Anwar","sequence":"additional","affiliation":[{"name":"Department of Pharmacology and Toxicology, College of Pharmacy, University of Hail","place":["Hail, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"449","DOI":"10.15537\/smj.2021.42.4.20210028","article-title":"Pattern of cancers in adolescent and young adults. 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