Potentially burdensome end‐of‐life transitions among nursing home residents with poor‐prognosis cancer
| Autor: | Areej El-Jawahri, Jennifer S. Temel, Clark DuMontier, Ryan D. Nipp, Sarah D. Berry, Susan L. Mitchell, Yoojin Lee, Daniel E. Lage |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Cancer Research Time Factors Activities of daily living Palliative care Comorbidity law.invention 0302 clinical medicine law Neoplasms Activities of Daily Living Odds Ratio Renal Insufficiency 030212 general & internal medicine Aged 80 and over Terminal Care Minimum Data Set education.field_of_study Dehydration Prognosis Intensive care unit humanities Hospitalization Intensive Care Units Oncology Geriatric oncology 030220 oncology & carcinogenesis Urinary Tract Infections Female End-of-life care medicine.medical_specialty Population Medicare Pneumonia Aspiration Article 03 medical and health sciences Sepsis medicine Humans education Aged Retrospective Studies business.industry Pneumonia Odds ratio United States Nursing Homes Hospice Care Emergency medicine business |
| Zdroj: | Cancer |
| ISSN: | 1097-0142 0008-543X |
| Popis: | BACKGROUND This study examined factors associated with potentially burdensome end-of-life (EOL) transitions between care settings among older adults with advanced cancer in nursing homes (NHs). METHODS A retrospective analysis of deceased older NH residents with poor-prognosis solid tumors was conducted with Medicare claims and the Minimum Data Set. A potentially burdensome transition was defined as 2 or more hospitalizations or an intensive care unit admission in the last 90 days of life. RESULTS Among 34,670 subjects, many had moderate to severe cognitive impairment (53.8%), full dependence in activities of daily living (ADLs; 66.5%), and comorbidities such as congestive heart failure (CHF; 29.3%) and chronic obstructive pulmonary disease (34.1%). Only 56.3% of the patients used hospice at any time in the 90 days before death; 36.0% of the patients experienced a potentially burdensome EOL transition, and this was higher among patients who did not receive hospice (45.4% vs 28.7%; P |
| Databáze: | OpenAIRE |
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