ASH Clinical News October 2015 | Page 29

CLINICAL NEWS Don’t Lose Sleep Over Surgeon’s Graveyard Shift Rest assured that surgeons who work the night before a daytime procedure don’t cause their patients any harm – despite concerns that sleep loss could negatively impact daytime performance, according to a report published in The New England Journal of Medicine. 38,978 patients were included in the retrospective study: 19,489 patients who were treated by a physician who worked from 12 a.m. to 7 a.m. the night before a daytime procedure, and 19,489 patients who were treated by a physician who had not worked after midnight. The risks of death, readmission, or complication within 30 days after the procedure were similar between the control group (■) and postmidnight group (■): Another Reason to Tie the Knot… Getting (and staying) married may increase the chances of survival for younger patients with acute myeloid leukemia (AML), according to a report published in Cancer. In an analysis of data from 5,541 patients with AML younger than 65 years, compared with married patients, the risk of premature death was: The report also found that insurance status and income affected the chances of survival: Medicaid-insured and uninsured patients had 21% and 23% higher risks of premature death, respectively, and patients with household incomes higher than the national median had a 9% lower risk. “As physicians, we often emphasize more of the biology of the cancer, especially with the recent focus on personalized medicine,” said lead author Luciano Jose Costa, MD, PhD. “But we need to pay the same attention to resources available to our patients, as this greatly impacts their chances to survive leukemia.” Source: Borate U, Mineishi S, Costa LJ. Nonbiological factors affecting survival in younger patients with acute myeloid leukemia. Cancer. 2015 September 14. [Epub ahead of print] 3,543 3,527 (18.2%) (18.1%) 20 15 10 1,385 1,287 (7.1%) (6.6%) 5 222 224 (1.1%) (1.1%) 0 Death Cutting Cost-Cutting Readmission Complication Source: Govindarajan A, Urbach DR, Kumar M, et al. Outcomes of daytime procedures performed by attending surgeons after night work. N Engl J Med. 2015;373;845-53. Fewer Americans are forgoing medical care because they could not afford it, according to an analysis from the U.S. Centers for Disease Control and Prevention (CDC). In 2014, 1 in 20 Americans (or 4.4%) said they skipped out on medical care they needed last year due to cost. That’s down from 5.9% in 2013, and the lowest percentage in 16 years, according to the CDC’s National Health Interview Survey. FOR SINGLE PATIENTS 23% HIGHER The survey, which was conducted among people of all ages between January and March 2015, does not offer an explanation of why fewer people are avoiding medical care because of costs, but the decrease does coincide with two significant changes in the American healthcare environment: increased access and affordability of health insurance under the Affordable Care Act and the expansion of Medicaid in some states. 4.4% skipped out on medical care due to cost. Source: Clarke TC, Ward BW, Freeman G, et al. Early release of selected estimates based on data from the January-March 2015 National Health Interview Survey. September 2015. FOR DIVORCED PATIENTS 15% HIGHER FOR WIDOWED PATIENTS 16% HIGHER Digging for Evidence of Leukemia Examination of skeletal remains from a woman alive during Europe’s Neolithic Age suggests that she battled a disease that is still prevalent today: leukemia. Paleontologists believe that, at 7,000 years old, this may be the oldest case of the blood cancer yet recorded. A detailed CT-scan analysis of the 30- to 40-yearold woman’s bones, simply called G61, found “an unusual loosening of the interior bone tissue” that are home to blood-forming stem cells, suggestive of leukemia, the researchers explained. None of the other specimens found at the site showed this pattern. Source: Senckenberg Center for Human Evolution and Paleoenvironment news release, August 31, 2015. ASHClinicalNews.org ASH Clinical News 27