Which Patients With Cancer Die at Home? A Study of Six European Countries Using Death Certificate Data

Cohen, Joachim; Houttekier, Dirk; Onwuteaka‐Philipsen, Bregje D.; Miccinesi, Guido; Addington‐Hall, Julia; Kaasa, Stein; Bilsen, Johan; Deliens, Luc

doi:10.1200/jco.2009.23.2850

Cited by 207 publications

(217 citation statements)

References 31 publications

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“…Although higher rates in comparison with prefer rates in some countries such as Canada (45%), Netherlands (31%) and United States (29%), the results of our patients with some other countries ratio such as Belgium (61%), Wales (60%), and United Kingdom (50%) are similar (Cohen et al, 2010;Lau et al, 2013;Wilson et al, 2013). However, this high rate can be explained by the low number of patients in our study.…”

Section: Discussionsupporting

confidence: 56%

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

Yıldırım

Tanrıverdi²

2014

Asian Pacific Journal of Cancer Prevention

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Background: Although previously studies have reported that most patients with malignancy prefer to die at home, this is not the real situation in clinical practice. Aim: In this study, we aimed to determine the characteristics of Turkish cancer patients admitted to the emergency department (ED) within one month before death. Materials and Method: This descriptive retrospective study focused on questions about how often and why patients with cancer visited the ED before death. A total of 107 individuals with cancer were divided into 2 groups: Group 1, patients with at least one visit in the final 4 weeks; and Group 2, patients with no visit to ED. Demographic and clinical features were compared between the two groups. Statistical analyses: Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression were used. Results: At least one visit to ED within one month before death was reported for 64 (60%) of the 107 cases. Of these 64 (Group 1), 38% (n=24) were discharged and 9% (n=6) died in the ED. The most common site of the primary tumor was the lung (n=24, 38%) and the most common symptom was dyspnea (92%). With the other 43 (40%) cancer patients not presenting to the ED within one month before death, they were more likely to be female with another type of cancer. Conclusions: Guidelines are needed for better management of cancer patients benefiting from visits to ED within the last month of life .

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Section: Discussionsupporting

confidence: 56%

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

Yıldırım

Tanrıverdi²

2014

Asian Pacific Journal of Cancer Prevention

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“…These findings are consistent with previous studies. 14,16,18,19,39,41 Third, only one of three caregivers completed Zarit's interview. Time restrictions and understanding problems were reported as the primary reasons for not completing them.…”

Section: Discussionmentioning

confidence: 99%

“…15,31, [39][40][41][42] The possibility of keeping terminally ill patients at home depends primarily on caregivers.…”

Section: Discussionmentioning

confidence: 99%

Can This Patient Be Discharged Home? Factors Associated With At-Home Death Among Patients With Cancer

Alonso-Babarro

Bruera

Varela-Cerdeira

et al. 2011

JCO

109

121

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Purpose The purpose of this study was to identify factors associated with at-home death among patients with advanced cancer and create a decision-making model for discharging patients from an acute-care hospital. Patients and Methods We conducted an observational cohort study to identify the association between place of death and the clinical and demographic characteristics of patients with advanced cancer who received care from a palliative home care team (PHCT) and of their primary caregivers. We used logistic regression analysis to identify the predictors of at-home death. Results We identified 380 patients who met the study inclusion criteria; of these, 245 patients (64%) died at home, 72 (19%) died in an acute-care hospital, 60 (16%) died in a palliative care unit, and three (1%) died in a nursing home. Median follow-up was 48 days. We included the 16 variables that were significant in univariate analysis in our decision-making model. Five variables predictive of at-home death were retained in the multivariate analysis: caregiver's preferred place of death, patients' preferred place of death, caregiver's perceived social support, number of hospital admission days, and number of PHCT visits. A subsequent reduced model including only those variables that were known at the time of discharge (caregivers' preferred place of death, patients' preferred place of death, and caregivers' perceived social support) had a sensitivity of 96% and a specificity of 81% in predicting place of death. Conclusion Asking a few simple patient- and family-centered questions may help to inform the decision regarding the best place for end-of-life care and death.

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“…Finally, it is not known how hospice or palliative care is able to facilitate death at home. 15 For instance, physician visits may be associated with death at home, raising the possibility that among hospice patients, a greater intensity of nursing visits might have a similar effect. 16 Answers to these questions could help hospices to prospectively identify those patients who are at increased risk of dying in nonpreferred settings.…”

Section: Introductionmentioning

confidence: 99%

Which Hospice Patients With Cancer Are Able to Die in the Setting of Their Choice? Results of a Retrospective Cohort Study

Jeurkar

Farrington

Craig

et al. 2012

JCO

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A B S T R A C T PurposeTo determine which hospice patients with cancer prefer to die at home and to define factors associated with an increased likelihood of dying at home. MethodsAn electronic health record-based retrospective cohort study was conducted in three hospice programs in Florida, Pennsylvania, and Wisconsin. Main measures included preferred versus actual site of death. ResultsOf 7,391 patients, preferences regarding place of death were determined at admission for 5,837 (79%). After adjusting for other characteristics, patients who preferred to die at home were more likely to die at home (adjusted proportions, 56.5% v 37.0%; odds ratio [OR], 2.21; 95% CI, 1.77 to 2.76). Among those patients (n ϭ 3,152) who preferred to die at home, in a multivariable logistic regression model, patients were more likely to die at home if they had at least one visit per day in the first 4 days of hospice care (adjusted proportions, 61% v 54%; OR, 1.23; 95% CI, 1.07 to 1.41), if they were married (63% v 54%; OR, 1.35; 95% CI, 1.10 to 1.44), and if they had an advance directive (65% v 50%; OR, 2.11; 95% CI, 1.54 to 2.65). Patients with moderate or severe pain were less likely to die at home (OR, 0.56; 95% CI, 0.45 to 0.64), as were patients with better functional status (higher Palliative Performance Scale score: Ͻ 40, 64.8%; 40 to 70, 50.2%; OR, 0.79; 95% CI, 0.67 to 0.93; Ͼ 70, 40.5%; OR, 0.53; 95% CI, 0.35 to 0.82). ConclusionIncreased hospice visit frequency may increase the likelihood of patients being able to die in the setting of their choice.

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Which Patients With Cancer Die at Home? A Study of Six European Countries Using Death Certificate Data

Cited by 207 publications

References 31 publications

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

Evaluation of Cancer Patients Admitted to the Emergency Department within One Month before Death in Turkey: What are the Problems Needing Attention?

Can This Patient Be Discharged Home? Factors Associated With At-Home Death Among Patients With Cancer

Which Hospice Patients With Cancer Are Able to Die in the Setting of Their Choice? Results of a Retrospective Cohort Study

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