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Utilization of medical interventions in hospitalized Mexican adults with cancer at the end of life in a referral hospital: The importance of early palliative care

Published online by Cambridge University Press:  07 March 2024

Silvia Rosa Allende-Pérez Open the ORCID record for Silvia Rosa Allende-Pérez [Opens in a new window] ,
Nadia Cristina Sandoval-Carrera ,
Leticia Asencio-Huertas ,
Oscar Rodríguez-Mayoral Open the ORCID record for Oscar Rodríguez-Mayoral [Opens in a new window] ,
Jacob Jonatan Cruz-Sánchez  and
Emma Verástegui-Avilés
Silvia Rosa Allende-Pérez*
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
Nadia Cristina Sandoval-Carrera
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
Leticia Asencio-Huertas
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
Oscar Rodríguez-Mayoral
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
Jacob Jonatan Cruz-Sánchez
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
Emma Verástegui-Avilés
Affiliation:
Palliative Care Service, National Cancer Institute, Mexico City, Mexico
*
Corresponding author: Silvia Allende-Pérez; Email: sallendep@incan.edu.mx
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Abstract

Objectives

To investigate the impact of early vs. late palliative care (PC) on the frequency of admissions to acute hospital settings and the utilization of end-of-life (EoL) interventions in cancer decedents.

Methods

In this single-center, cross-sectional study, we examined the frequency of intensive care unit (ICU) and emergency department (ED) admissions among adult cancer decedents between 2018 and 2022 in a referral hospital in México. Additionally, we assessed EoL medical interventions, categorizing patients into 3 groups: those who received early PC (EPC), late PC (LPC), and those who did not receive PC (NPC).

Results

We analyzed data from 1762 patients, averaging 56 ± 16.3 years old, with a predominant representation of women (56.8%). PC was administered to 45.2% of patients, but EPC was limited to only 12.3%. The median time from the initiation of PC to death was 5 days (interquartile range: 2.0–31.5). Hematological malignancies were the most prevalent, affecting 21.5% of patients. EPC recipients demonstrated notable reductions in ICU and ED admissions, as well as diminished utilization of chemotherapy, radiotherapy (RT), antibiotics, blood transfusions, and surgery when compared to both LPC and NPC groups. EPC also exhibited fewer medical interventions in the last 14 days of life, except for RT.

Significance of results

The findings of this study indicate that a significant proportion of EoL cancer patients receive PC; however, few receive EPC, emphasizing the need to improve accessibility to these services. Moreover, the results underscore the importance of thoughtful deliberation regarding the application of EoL medical interventions in cancer patients.

Keywords

Early palliative carecancermedical interventionsend of life
Type
Original Article
Information
Palliative & Supportive Care , First View , pp. 1 - 8
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Copyright
© The Author(s), 2024. Published by Cambridge University Press.

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