{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:47:09Z","timestamp":1760244429973,"version":"build-2065373602"},"reference-count":46,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["8217110606"],"award-info":[{"award-number":["8217110606"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Immunodeficiency diseases (IDDs) are associated with an increased proportion of cancer-related morbidity. However, the relationship between IDDs and malignancy readmissions has not been well described. Understanding this relationship could help us to develop a more reasonable discharge plan in the special tumor population. Methods: Using the Nationwide Readmissions Database, we established a retrospective cohort study that included patients with the 16 most common malignancies, and we defined two groups: non-immunodeficiency diseases (NOIDDs) and IDDs. Results: To identify whether the presence or absence of IDDs was associated with readmission, we identified 603,831 patients with malignancies at their time of readmission in which 0.8% had IDDs and in which readmission occurred in 47.3%. Compared with NOIDDs, patients with IDDs had a higher risk of 30-day (hazard ratio (HR) of 1.32; 95% CI of 1.25\u20131.40), 90-day (HR of 1.27; 95% CI of 1.21\u20131.34) and 180-day readmission (HR of 1.28; 95% CI of 1.22\u20131.35). More than one third (37.9%) of patients with IDDs had readmissions that occurred within 30 days and most (82.4%) of them were UPRs. An IDD was an independent risk factor for readmission in patients with colorectal cancer (HR of 1.32; 95% CI of 1.01\u20131.72), lung cancer (HR of 1.23; 95% CI of 1.02\u20131.48), non-Hodgkin\u2019s lymphoma (NHL) (HR of 1.16; 95% CI of 1.04\u20131.28), prostate cancer (HR of 1.45; 95% CI of 1.07\u20131.96) or stomach cancer (HR of 2.34; 95% CI of 1.33\u20134.14). Anemia (44.2%), bacterial infections (28.6%) and pneumonia (13.9%) were the 30-day UPR causes in these populations. (4) Conclusions: IDDs were independently associated with higher readmission risks for some malignant tumors. Strategies should be considered to prevent the causes of readmission as a post discharge plan.<\/jats:p>","DOI":"10.3390\/cancers15010088","type":"journal-article","created":{"date-parts":[[2022,12,27]],"date-time":"2022-12-27T07:31:56Z","timestamp":1672126316000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Immunodeficiencies Push Readmissions in Malignant Tumor Patients: A Retrospective Cohort Study Based on the Nationwide Readmission Database"],"prefix":"10.3390","volume":"15","author":[{"given":"Wenchen","family":"Wang","sequence":"first","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin 300071, China"},{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2176-593X","authenticated-orcid":false,"given":"Qingyu","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7092-508X","authenticated-orcid":false,"given":"Yiping","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital, Shandong First Medical University, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yalin","family":"Han","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yonggan","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanshen","family":"Kuang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuning","family":"Wang","sequence":"additional","affiliation":[{"name":"The Air Force Hospital of Northern Theater PLA, Shenyang 110016, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bobin","family":"Ning","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mu","family":"Ke","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhipeng","family":"Teng","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sen","family":"Li","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongyi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7413-080X","authenticated-orcid":false,"given":"Xiude","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shandong Provincial Hospital, Shandong First Medical University, Jinan 250021, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7006-0741","authenticated-orcid":false,"given":"Baoqing","family":"Jia","sequence":"additional","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin 300071, China"},{"name":"Department of General Surgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1038\/nature07943","article-title":"The cancer genome","volume":"458","author":"Stratton","year":"2009","journal-title":"Nature"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1038\/s41568-020-0290-x","article-title":"A compendium of mutational cancer driver genes","volume":"20","year":"2020","journal-title":"Nat. Rev. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1038\/nrc3670","article-title":"Tumour antigens recognized by T lymphocytes: At the core of cancer immunotherapy","volume":"14","author":"Coulie","year":"2014","journal-title":"Nat. Rev. Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1038\/s41568-021-00339-z","article-title":"Antigen presentation in cancer: Insights into tumour immunogenicity and immune evasion","volume":"21","author":"Jhunjhunwala","year":"2021","journal-title":"Nat. Rev. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1038\/s41573-021-00387-y","article-title":"Identification of neoantigens for individualized therapeutic cancer vaccines","volume":"21","author":"Lang","year":"2022","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1056\/NEJMc1508163","article-title":"Genetic Basis for Clinical Response to CTLA-4 Blockade in Melanoma","volume":"373","author":"Chan","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1056\/NEJMoa2119662","article-title":"Neoantigen T-Cell Receptor Gene Therapy in Pancreatic Cancer","volume":"386","author":"Leidner","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1038\/s41568-020-0281-y","article-title":"Neutrophil diversity and plasticity in tumour progression and therapy","volume":"20","author":"Jaillon","year":"2020","journal-title":"Nat. Rev. Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.cmet.2019.06.001","article-title":"Macrophages and Metabolism in the Tumor Microenvironment","volume":"30","author":"Vitale","year":"2019","journal-title":"Cell Metab."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Wolf, N.K., Kissiov, D.U., and Raulet, D.H. (Nat. Rev. Immunol., 2022). Roles of natural killer cells in immunity to cancer, and applications to immunotherapy, Nat. Rev. Immunol., ahead of print.","DOI":"10.1038\/s41577-022-00732-1"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(21)01234-4","article-title":"Pembrolizumab plus chemotherapy versus chemotherapy alone for first-line treatment of advanced oesophageal cancer (KEYNOTE-590): A randomised, placebo-controlled, phase 3 study","volume":"398","author":"Sun","year":"2021","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1056\/NEJMoa2202170","article-title":"Neoadjuvant Nivolumab Plus Chemotherapy in Resectable Lung Cancer","volume":"386","author":"Forde","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/S2213-2600(20)30391-X","article-title":"Pembrolizumab with or without radiotherapy for metastatic non-small-cell lung cancer: A pooled analysis of two randomised trials","volume":"9","author":"Theelen","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/S0140-6736(08)61199-X","article-title":"Common variable immunodeficiency: A new look at an old disease","volume":"372","author":"Park","year":"2008","journal-title":"Lancet"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1111\/j.1365-2249.2006.03292.x","article-title":"The European internet-based patient and research database for primary immunodeficiencies: Results 2004\u201306","volume":"147","author":"Gathmann","year":"2007","journal-title":"Clin. Exp. Immunol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0140-6736(85)91037-2","article-title":"Prospective study of cancer in patients with hypogammaglobulinaemia","volume":"1","author":"Kinlen","year":"1985","journal-title":"Lancet"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3135","DOI":"10.3389\/fimmu.2018.03135","article-title":"CVID-Associated Tumors: Czech Nationwide Study Focused on Epidemiology, Immunology, and Genetic Background in a Cohort of Patients With CVID","volume":"9","author":"Kralickova","year":"2018","journal-title":"Front. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S1473-3099(15)00056-0","article-title":"Future challenges for clinical care of an ageing population infected with HIV: A modelling study","volume":"15","author":"Smit","year":"2015","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1056\/NEJMra1615896","article-title":"HIV-Associated Cancers and Related Diseases","volume":"378","author":"Yarchoan","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1097\/QAD.0000000000000222","article-title":"Causes of death among HIV-infected patients in France in 2010 (national survey): Trends since 2000","volume":"28","author":"Morlat","year":"2014","journal-title":"Aids"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e495","DOI":"10.1016\/S2352-3018(17)30125-X","article-title":"Cancer risk in HIV-infected people in the USA from 1996 to 2012: A population-based, registry-linkage study","volume":"4","author":"Shiels","year":"2017","journal-title":"Lancet HIV"},{"key":"ref_22","unstructured":"AHRQ (2022, November 21). Introduction to the HCUP Nationwide Readmissions Database(NRD) 2010\u20132018. Available online: https:\/\/datasetdirectory.disabilitystatistics.org\/show\/43."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J. Clin."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1007\/s10875-019-00737-x","article-title":"Human Inborn Errors of Immunity: 2019 Update on the Classification from the International Union of Immunological Societies Expert Committee","volume":"40","author":"Tangye","year":"2020","journal-title":"J. Clin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1007\/s10875-021-00980-1","article-title":"The Ever-Increasing Array of Novel Inborn Errors of Immunity: An Interim Update by the IUIS Committee","volume":"41","author":"Tangye","year":"2021","journal-title":"J. Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Nagata, N., Nishijima, T., Niikura, R., Yokoyama, T., Matsushita, Y., Watanabe, K., and Gatanaga, H. (2018). Increased risk of non-AIDS-defining cancers in Asian HIV-infected patients: A long-term cohort study. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4963-8"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1953","DOI":"10.1182\/blood-2012-05-431064","article-title":"Malignancies are the major cause of death in patients with adult onset common variable immunodeficiency","volume":"120","author":"Quinti","year":"2012","journal-title":"Blood"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1056\/NEJMsa0803563","article-title":"Rehospitalizations among patients in the Medicare fee-for-service program","volume":"360","author":"Jencks","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1001\/jamaoncol.2021.7643","article-title":"Effect of a Symptom Monitoring Intervention for Patients Hospitalized With Advanced Cancer: A Randomized Clinical Trial","volume":"8","author":"Nipp","year":"2022","journal-title":"JAMA Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1905","DOI":"10.1016\/S0140-6736(21)00768-6","article-title":"Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: A prospective study in a panel of hospitals","volume":"397","author":"McHugh","year":"2021","journal-title":"Lancet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.jaip.2015.07.025","article-title":"International Consensus Document (ICON): Common Variable Immunodeficiency Disorders","volume":"4","author":"Bonilla","year":"2016","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1006\/clim.1999.4725","article-title":"Common variable immunodeficiency: Clinical and immunological features of 248 patients","volume":"92","author":"Bodian","year":"1999","journal-title":"Clin. Immunol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1007\/s10875-022-01291-9","article-title":"Distinct CD8 T Cell Populations with Differential Exhaustion Profiles Associate with Secondary Complications in Common Variable Immunodeficiency","volume":"42","author":"Klocperk","year":"2022","journal-title":"J. Clin. Immunol"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ueckermann, V., Janse van Rensburg, L., Pannell, N., and Ehlers, M. (2022). Characteristics and outcomes of patients admitted to a tertiary academic hospital in Pretoria with HIV and severe pneumonia: A retrospective cohort study. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07522-z"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1086\/520178","article-title":"Human immunodeficiency virus infection, anemia, and survival","volume":"29","author":"Moore","year":"1999","journal-title":"Clin. Infect. Dis."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1086\/383031","article-title":"Anemia in HIV infection: Clinical impact and evidence-based management strategies","volume":"38","author":"Volberding","year":"2004","journal-title":"Clin. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1182\/blood-2014-06-583260","article-title":"Autoimmune and other cytopenias in primary immunodeficiencies: Pathomechanisms, novel differential diagnoses, and treatment","volume":"124","author":"Seidel","year":"2014","journal-title":"Blood"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1054\/blre.2001.0185","article-title":"Hematologic complications of primary immune deficiencies","volume":"16","year":"2002","journal-title":"Blood Rev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"11s","DOI":"10.1016\/j.amjmed.2003.12.008","article-title":"Prevalence and outcomes of anemia in cancer: A systematic review of the literature","volume":"116","author":"Knight","year":"2004","journal-title":"Am. J. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1016\/j.ejca.2004.06.019","article-title":"The European Cancer Anaemia Survey (ECAS): A large, multinational, prospective survey defining the prevalence, incidence, and treatment of anaemia in cancer patients","volume":"40","author":"Ludwig","year":"2004","journal-title":"Eur. J. Cancer"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1056\/NEJM199005243222103","article-title":"Recombinant human erythropoietin for patients with AIDS treated with zidovudine","volume":"322","author":"Fischl","year":"1990","journal-title":"N. Engl. J. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1182\/blood.2019002062","article-title":"Common variable immune deficiency: Case studies","volume":"134","year":"2019","journal-title":"Blood"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1050","DOI":"10.1016\/j.cgh.2013.02.024","article-title":"Diagnosis and treatment of gastrointestinal disorders in patients with primary immunodeficiency","volume":"11","author":"Agarwal","year":"2013","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1182\/blood-2018-06-856500","article-title":"Anemia of inflammation","volume":"133","author":"Weiss","year":"2019","journal-title":"Blood"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1111\/j.1365-2141.2011.08880.x","article-title":"Efficacy and safety of rituximab in common variable immunodeficiency-associated immune cytopenias: A retrospective multicentre study on 33 patients","volume":"155","author":"Gobert","year":"2011","journal-title":"Br. J. Haematol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1365-2141.2010.08444.x","article-title":"Guidelines on the use of irradiated blood components prepared by the British Committee for Standards in Haematology blood transfusion task force","volume":"152","author":"Treleaven","year":"2011","journal-title":"Br. J. Haematol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/1\/88\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:49:14Z","timestamp":1760147354000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/15\/1\/88"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,23]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["cancers15010088"],"URL":"https:\/\/doi.org\/10.3390\/cancers15010088","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2022,12,23]]}}}