Sociodemographic and clinical factors for non-hospital deaths among cancer patients: A nationwide population-based cohort study

Zhuang, Qingyuan; Lau, Zheng Yi; Ong, Whee Sze; Yang, Grace Meijuan; Tan, Kelvin Bryan; Ong, Marcus Eng Hock; Wong, Ting Hway

doi:10.1371/journal.pone.0232219

Cited by 15 publications

(17 citation statements)

References 47 publications

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“…This indicates that while some gains have been made, opportunities for further improvement remain. In contrast to studies from other countries, Canadian in-hospital death rates remain higher than those in the United States, but are similar to those in Taiwan and Singapore, and lower than those in Norway [ 22 , 23 , 24 ].…”

Section: Discussioncontrasting

confidence: 78%

Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time

et al. 2021

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This retrospective cohort study of cancer decedents during 2004–2015 examined end-of-life cancer care quality indicators (QIs) in the provinces of British Columbia (BC), Ontario, and Nova Scotia (NS). These included: emergency department use, in-patient hospitalization, intensive care unit admissions, physician house calls, home care visits, and death experienced in hospital. Ontario saw the greatest 12-year decrease in in-hospital deaths from 52.8% to 41.1%. Hospitalization rates within 30 days of death decreased in Ontario, increased in NS, and remained the same in BC. Ontario’s usage of aggressive end-of-life measures changed very little, while BC increased their utilization rates. Supportive care use increased in both NS and Ontario. Those who were male or living in a lower income/smaller community (in Ontario) were associated with a decreased likelihood of receiving supportive care. Despite the shift in focus to providing hospice and home care services, approximately 50% of oncology patients are still dying in hospital and 11.7% of patients overall are subject to aggressive care measures that may be out of line with their desire for comfort care. Supportive care use is increasing, but providers must ensure that Canadians are connected to palliative services, as its utilization improves a wide variety of outcomes.

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Section: Discussioncontrasting

confidence: 78%

Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time

et al. 2021

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“…There is an increased rate of hospitalisation toward the end of life of cancer patients. Studies have found that about half of cancer-related deaths occurred in acute hospitals (36)(37)(38). While the reasons for admission were not captured in our study, it would not be unreasonable to infer that the inpatients were more symptomatic and required a higher level of care that could not be administered in the outpatient setting.…”

Section: Development Of the Nccs Prognostic Modelmentioning

confidence: 75%

Improving the prognostication of patients receiving palliative radiotherapy

Sin¹,

Ong²,

Pang³

et al. 2021

Ther Radiol Oncol

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Background: We aim to develop a prognostic model for patients undergoing palliative radiotherapy (RT), and to compare its performance with alternative prognostic models.Methods: A total of 288 patients were prospectively recruited and randomly split into a 60% training cohort and a 40% testing cohort for model development and validation. Prognosticators were identified via Cox regression analyses. Additional parametric survival models with the identified prognosticators included as covariates were fitted. Model fit and discrimination ability of various fitted models were compared to identify the best model. Patients were grouped according to the number of prognostic factors of the NRF model and TEACHH model for comparison.Results: In the training cohort, neutrophil-lymphocyte ratio (NLR) ≥6, inpatient status at start of RT, prior chemotherapy within 3 months of starting RT, and Palliative Performance Scale score ≤50% were independently and adversely associated with OS. Amongst the various models considered, the log-logistic accelerated failure time (AFT) model had the best performance [log-logistic AFT: explained variation R 2

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“…The burden of cancer continues to increase worldwide. According to the World Health Organization (WHO), cancer is the second leading cause of death in the world, accounting for approximately 9.6 million deaths in 2018 [34]. Numerous studies suggest that redox imbalance may be a factor predisposing to cancer development [9,35,36].…”

Section: Discussionmentioning

confidence: 99%

Plasma and Urine Total Antioxidant Capacity in Patients With Adrenal Tumors

Choromańska

Myśliwiec

Kozłowski

et al. 2021

Preprint

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Total antioxidant capacity better characterizes the redox status of the biological system than the determination of individual antioxidants separately. This study is the first to assess the total antioxidant/oxidant status in the plasma and urine of patients with adrenal tumors. The study group consisted of 60 patients (31 women and 29 men) with adrenal masses, classified into three subgroups: non-functional incidentaloma, pheochromocytoma and Cushing’s/Conn’s adenoma. The number of patients was set a priori based on our previous experiment (α = 0.05, test power = 0.9) Plasma total antioxidant capacity (TAC) was increased in incidentaloma patients, whereas in pheochromocytoma group was decreased. Plasma and urine total oxidant status (TOS) and oxidative stress index (OSI) were significantly higher in patients with adrenal tumors. Ferric reducing antioxidant potential (FRAP) was decreased in plasma and urine, while DPPH (2,2-diphenyl-1-picrylhydrazyl) antiradical activity only in plasma of patients with adrenal masses. In pheochromocytoma patients, plasma and urine TAC, as well as plasma DPPH and FRAP correlated positively with methanephrine and normethanephrine. Reduced levels of TAC, DPPH and FRAP clearly indicate a reduced ability to scavenge free radicals and thus a lack of effective protection against oxidative stress in patients with adrenal tumors. Therefore, those patients are especially vulnerable to oxidative stress and oxidative damage, which can lead to impaired cellular metabolism. Both plasma and urine redox biomarkers can be used to assess systemic antioxidant status in adrenal tumor patients.

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Sociodemographic and clinical factors for non-hospital deaths among cancer patients: A nationwide population-based cohort study

Cited by 15 publications

References 47 publications

Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time

Quality of End-of-Life Cancer Care in Canada: A 12-Year Retrospective Analysis of Three Provinces’ Administrative Health Care Data Evaluating Changes over Time

Improving the prognostication of patients receiving palliative radiotherapy

Plasma and Urine Total Antioxidant Capacity in Patients With Adrenal Tumors

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