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| [PMID]: | 28954284 |
| [Au] Autor: | Falchook AD; Dusetzina SB; Tian F; Basak R; Selvam N; Chen RC |
| [Ad] Endereço: | Department of Radiation Oncology, Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, Lineberger Comprehensive Cancer Center, Department of Health Policy and Management, Gillings School of Global Public Health, and Cecil G. Sheps Center for Health Services Research, Univ |
| [Ti] Título: | Aggressive End-of-Life Care for Metastatic Cancer Patients Younger Than Age 65 Years. |
| [So] Source: | J Natl Cancer Inst;109(9), 2017 Sep 01. | | [Is] ISSN: | 1460-2105 |
| [Cp] País de publicação: | United States |
| [La] Idioma: | eng |
| [Ab] Resumo: | Background: Aggressive medical care at the end of life can be harmful to patients and families, but its prevalence in use among younger cancer patients is unknown. The goal of the study was to report on the use of aggressive care and hospice services for patients younger than age 65 years. Methods: Using the HealthCore Integrated Research Database, we analyzed patients who died between 2007 and 2014 with metastatic lung (n = 12 764), colorectal (n = 5207), breast (n = 5855), pancreatic (n = 3397), or prostate (n = 1508) cancer. Based on published quality measures, we assessed uses of chemotherapy, intensive care, emergency room visits, and hospice care at the end of life. We examined additional items including radiotherapy, invasive procedures, hospitalization, and in-hospital deaths. Multivariable modified Poisson regression models were used to adjust for age, sex, geographic region, rural/urban location, year of death, and regional education and income measures. Results: Across the five cancers, 10.1% to 14.1% of patients received chemotherapy within the last 14 days of life, 15.9% to 20.6% received intensive care in last 30 days, and 1.5% to 2.5% went to the emergency room two or more times in last 30 days. Hospice enrollment at least three days before death was 54.4% to 59.6%. However, 55.3% to 59.3% of patients had a hospital admission in the last 30 days, and one-third died (30.3%-35.4%) in the hospital. Conclusions: There was low use of cancer-directed treatment at the end of life for younger cancer patients, and hospice use was higher than 50%. However, there was a relatively high utilization of hospital-based care. These results demonstrate an opportunity for continued improvements in the provision of high-value, patient-centered care at the end of life. |
| [Mh] Termos MeSH primário: |
Neoplasias/epidemiologia
Neoplasias/terapia
Assistência Terminal
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| [Mh] Termos MeSH secundário: |
Adulto
Fatores Etários
Terapia Combinada
Feminino
Cuidados Paliativos na Terminalidade da Vida
Mortalidade Hospitalar
Hospitalização
Seres Humanos
Masculino
Meia-Idade
Metástase Neoplásica
Estadiamento de Neoplasias
Neoplasias/diagnóstico
Vigilância da População
Assistência Terminal/métodos
Resultado do Tratamento
Estados Unidos/epidemiologia
Adulto Jovem
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| [Pt] Tipo de publicação: | JOURNAL ARTICLE |
| [Em] Mês de entrada: | 1710 |
| [Cu] Atualização por classe: | 171003 |
[Lr] Data última revisão:
| 171003 |
| [Sb] Subgrupo de revista: | IM |
| [Da] Data de entrada para processamento: | 170928 |
| [St] Status: | MEDLINE |
| [do] DOI: | 10.1093/jnci/djx028 |
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