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The impact of palliative care on the aggressiveness of end-of-life care in patients with advanced pancreatic cancer
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The impact of palliative care on the aggressiveness of end-of-life care in patients with advanced pancreatic cancer
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The impact of palliative care on the aggressiveness of end-of-life care in patients with advanced pancreatic cancer
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Dissertation
The impact of palliative care on the aggressiveness of end-of-life care in patients with advanced pancreatic cancer
2013
Overview
Our objective was to examine the impact of palliative care (PC) on aggressive care near death for patients with advanced pancreatic cancer. Measures of aggressive care included (i) chemotherapy within 14 days of death; (ii) more than one emergency department (ED) visit; (iii) more than one hospitalization; and (iv) at least one intensive care unit (ICU) admission, all within 30 days of death. A retrospective population-based cohort study was conducted with patients diagnosed with advanced pancreatic cancer in Ontario. Multivariable logistic analyses were performed. Our final cohort consisted of 5,381 patients (median survival of 75 days). 52% received a PC consultation. PC consultation was associated with decreased use of chemotherapy near death (OR=0.34); and lower risk of ICU admission (OR=0.12), multiple ED visits (OR=0.19), and multiple hospitalizations near death (OR=0.24). A per unit increase in the monthly rate of PC visits was associated with lower odds of aggressive care.
