Aggressiveness of end-of-life cancer care: what happens in clinical practice?
| Autor: | María Luisa Solano-Garzón, Ana Isabel Bravo-Guillén, Vicente Escudero-Vilaplana, Ricardo González del Val, Bárbara Fox, Roberto Collado-Borrell, María Sanjurjo, Javier Valero-Salinas, E García-Martín, José Manuel Cano-González, Eva González-Haba, Nuria Pérez de Lucas, Belén Marzal-Alfaro, María Sánchez-Isac, Miguel Martín |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Palliative care Cohort Studies 03 medical and health sciences 0302 clinical medicine Neoplasms Acute care Health care medicine Humans Longitudinal Studies 030212 general & internal medicine Aged Retrospective Studies Terminal Care business.industry Nursing research Cancer Retrospective cohort study medicine.disease Hospice Care Oncology 030220 oncology & carcinogenesis Population study Female Observational study business |
| Zdroj: | Supportive Care in Cancer. 29:3121-3127 |
| ISSN: | 1433-7339 0941-4355 |
| DOI: | 10.1007/s00520-020-05828-9 |
| Popis: | End-of-life cancer care varies widely, and very few centers evaluate it systematically. Our objective was to assess indicators of the aggressiveness of end-of-life cancer care in clinical practice. An observational, longitudinal, and retrospective cohort study was conducted at a tertiary hospital. Eligible patients were at least 18 years old, had a solid tumor, were followed up by the Oncology Department, and had died because of cancer or associated complications during 2017. We used the criteria of Earle et al. (J Clin Oncol 21(6):1133–1138, 2003) to assess the aggressiveness of care. Multivariate logistic regression analyses were performed to characterize factors associated with aggressiveness of therapy. The study population comprised 684 patients. Eighty-eight patients (12.9%) received anti-cancer treatment during the last 14 days of their lives, and 62 patients (9.1%) started a new treatment line in the last 30 days. During the last month of life, 102 patients (14.9%) visited the ER, 80 patients (11.7%) were hospitalized more than once, and 26 (3.8%) were admitted to the ICU. A total of 326 patients (47.7%) died in the acute care unit. A total of 417 patients (61.0%) were followed by the Palliative Care Unit, and in 54 cases (13.0%), this care started during the last 3 days of life. The use of anti-cancer therapies and health care services in our clinical practice, except for the ICU, did not meet the Earle criteria for high-quality care. Concerning hospice care, more than half of the patients received hospice services before death, although in some cases, this care started close to the time of death. |
| Databáze: | OpenAIRE |
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