Clinical Study

Health resource utilisation by patients with neuroendocrine tumours with or without carcinoid heart disease: a multinational study

13 Nov 2020
Hugo Tanaka, Deise Uema, Juliana FM Rego, Rui F Weschenfelder, Nathalia D’Agustini, Duilio R Rocha Filho, Juan M O'Connor, Romina Luca, Jose Eduardo R Nuñez, Milton José de Barros e Silva, Rachel P Riechelmann

Background: Carcinoid heart disease (CHD) is a rare and severe complication from carcinoid syndrome which may be associated with high health resource utilisation (HRU). We aimed to compare HRU between patients with and without CHD.

Methods: Multicentre retrospective study of 137 consecutive patients with neuroendocrine tumours (NET) and elevated urinary 5-hydroxyindoleacetic acid treated in seven large hospitals in Latin America. We used the chi-squared test for binary variables and the Mann–Whitney test for quantitative correlations. Variables were entered into a multivariable linear regression model for higher HRU.

Results: One-third of the patients had (45) had CHD. Patients with CHD had significantly more emergency visits and echocardiograms as compared to patients without CHD. In the bivariate models, CHD (R2 = 0.61, p = 0.01), private health system (R2 = 0.63, p = 0.02) and simultaneous cardiovascular comorbidities (R2 = 0.61, p = 0.04) were associated with a higher HRU. The multivariate model pointed out the accumulated effect of variables on HRU (R2 = 0.2, p < 0.01).

Conclusions: NET patients with CHD present higher HRU independently of other clinical factors or health system. Effectively treating carcinoid syndrome, and likely delaying the onset of CHD, may potentially reduce the amount of HRU by these patients.