A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Effect of Palliative Care Decision on Use of Hospital Services in Pancreatic Cancer Patients: A Retrospective Study
Tekijät: Miinalainen Sofia, Rissanen Antti, Leskela Riikka-Leena, Saarto Tiina, Hirvonen Outi, Anttonen Anu
Julkaisuvuosi: 2022
Journal: Anticancer Research
Tietokannassa oleva lehden nimi: Anticancer research
Lehden akronyymi: Anticancer Res
Vuosikerta: 42
Numero: 11
Aloitussivu: 5457
Lopetussivu: 5463
ISSN: 0250-7005
eISSN: 1791-7530
DOI: https://doi.org/10.21873/anticanres.16050
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/177251377
Background/aim: Continuing chemotherapy or using hospital services near the end of life (EOL) and delaying the approach to palliative care (PC) services are factors impairing quality of life near the EOL.
Patients and methods: Records of patients with pancreatic cancer treated at Helsinki University Hospital in 2013 and deceased by the end of 2014 were reviewed (N=221). The PC decision establishes the point when anticancer treatment is interrupted and the focus shifts to symptom-centered PC. The timing of the PC decision, referrals to specialized PC, use of hospital services at the EOL, and place of death were examined.
Results: The median overall survival was 13 months from diagnosis. The PC decision was made <30 days prior to death or not at all for 44% of patients. In addition, 68% of these patients used hospital service in the last month of life compared to 32% of patients with an earlier PC decision (p<0.001). A later or lacking PC decision correlated with a larger proportion of deaths in a secondary or tertiary hospital (64% vs. 36%), but the difference was not statistically significant (p=0.25).
Conclusion: A late or lacking PC decision for patients with pancreatic cancer was found in almost half of the patients. There was a significant difference in the use of hospital services depending on the timing of the decision. An earlier PC decision might improve EOL care, since a late or lacking PC decision relates to a more abundant use of hospital services and an increased risk of hospital deaths.
Ladattava julkaisu This is an electronic reprint of the original article. |