Patients with cancer and hospital admissions: disease trajectory and strategic choices. in BMJ supportive & palliative care / BMJ Support Palliat Care. 2023 Sep 13:spcare-2023-004574. doi: 10.1136/spcare-2023-004574.
2023
AO Cuneo
AOU Alessandria
Tipo pubblicazione
Journal Article
Autori/Collaboratori (14)Vedi tutti...
Milanesio M
Medical Oncology, AO S.Croce e Carle, Cuneo, Italy.
Ippoliti R
Department of Jurisprudence and Political Economic and Social Sciences, University of Eastern Piedmont Amedeo Avogadro, Alessandria, Piemonte, Italy.
Persano I
Medical Oncology, AO S.Croce e Carle, Cuneo, Italy.
et alii...
Abstract
OBJECTIVES: Hospital admission (HA) in cancer history is a common, repeated and frequently unplanned event. The emergency departments (EDs) and the oncological outpatient service (OOS) are the ordinary way of entry. We studied the reasons of admission, pathways of access and discharge and prognostic factors in a population of admitted patients with cancer. METHODS: The health records of the admitted patients in the oncological ward of a referral hospital in a 6-month period were retrieved and analysed. The characteristics of those admitted in the last 3?months of life were compared with the other group. RESULTS: Among the 147 HA, 79.5% were unplanned, 48.9% passing through the ED and 30.6% through the OOS; 56.5% were due to cancer-related symptoms; 50.3% occurred in the last 3?months of life. Median overall survival was 90 days (95% IC 53.1-126.9). Independent prognostic factors for survival were: being admitted for symptoms, referral through the ED and not being discharged at home. CONCLUSIONS: Hospital is a turning point in the cancer care pathway. Patients needing HA have a dismal prognosis, half of them being in the last 3 months of life. This group can be identified using universally available variables.
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PMID : 37704262
DOI : 10.1136/spcare-2023-004574
Keywords
symptoms and symptom management; prognosis; hospital care; end of life care; cancer;