End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage.
geriatric oncology; population-based data; specialized palliative care; terminal healthcare utilization; Oncology; Cancer Research
Abstract :
[en] This study aims to describe end-of-life (EOL) care in older patients with cancer and investigate the association between geriatric assessment (GA) results and specialized palliative care (SPC) use. Older patients with a new cancer diagnosis (2009-2015) originally included in a previous multicentric study were selected if they died before the end of follow-up (2019). At the time of cancer diagnosis, patients underwent geriatric screening with Geriatric 8 (G8) followed by GA in case of a G8 score ≤14/17. These data were linked to the cancer registry and healthcare reimbursement data for follow-up. EOL care was assessed in the last three months before death, and associations were analyzed using logistic regression. A total of 3546 deceased older patients with cancer with a median age of 79 years at diagnosis were included. Breast, colon, and lung cancer were the most common diagnoses. In the last three months of life, 76.3% were hospitalized, 49.1% had an emergency department visit, and 43.5% received SPC. In total, 55.0% died in the hospital (38.5% in a non-palliative care unit and 16.4% in a palliative care unit). In multivariable analyses, functional and cognitive impairment at cancer diagnosis was associated with less SPC. Further research on optimizing EOL healthcare utilization and broadening access to SPC is needed.
Disciplines :
Oncology
Author, co-author :
Depoorter, Victoria ; Department of Oncology, KU Leuven, 3000 Leuven, Belgium
Vanschoenbeek, Katrijn; Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Decoster, Lore; Department of Medical Oncology, Oncologisch Centrum, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
Silversmit, Geert ; Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Debruyne, Philip R ; Division of Medical Oncology, Kortrijk Cancer Centre, AZ Groeninge, 8500 Kortrijk, Belgium ; School of Life Sciences, Medical Technology Research Centre (MTRC), Anglia Ruskin University, Cambridge CB1 1PT, UK ; School of Nursing & Midwifery, University of Plymouth, Plymouth PL4 8AA, UK
De Groof, Inge; Department of Geriatric Medicine, Iridium Cancer Network Antwerp, Sint-Augustinus, 2610 Wilrijk, Belgium
Bron, Dominique; Department of Hematology, ULB-Institute Jules Bordet, 1070 Brussels, Belgium
Cornélis, Frank; Department of Medical Oncology, Cliniques Universitaires Saint-Luc-UCLouvain, 1200 Brussels, Belgium
Luce, Sylvie; Department Medical Oncology, University Hospital Erasme, Université Libre de Bruxelles ULB, 1000 Brussels, Belgium
Focan, Christian; Department of Oncology, Groupe Santé CHC-Liège, Clinique CHC-MontLégia, 4000 Liège, Belgium
Verschaeve, Vincent; Department of Medical Oncology, GHDC Grand Hôpital de Charleroi, 6000 Charleroi, Belgium
Debugne, Gwenaëlle; Department of Geriatric Medicine, Centre Hospitalier de Mouscron, 7700 Mouscron, Belgium
Langenaeken, Christine; Department of Medical Oncology, AZ Klina, 2930 Brasschaat, Belgium
Van Den Bulck, Heidi; Department of Medical Oncology, Imelda Hospital, 2820 Bonheiden, Belgium
Goeminne, Jean-Charles; Department of Medical Oncology, CHU-UCL-Namur, 5530 Namur, Belgium
Teurfs, Wesley; Department Medical Oncology, ZNA Stuivenberg, 2060 Antwerp, Belgium
Jerusalem, Guy ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'oncologie médicale
Schrijvers, Dirk; Department of Medical Oncology, ZNA Middelheim, 2020 Antwerp, Belgium
Petit, Bénédicte; Department of Medical Oncology, Centre Hospitalier Jolimont, 7100 La Louvière, Belgium
Rasschaert, Marika; Department of Medical Oncology, University Hospital Antwerp, 2650 Edegem, Belgium
Praet, Jean-Philippe; Department of Geriatric Medicine, CHU St-Pierre, Free Universities Brussels, 1000 Brussels, Belgium
Vandenborre, Katherine; Department of Medical Oncology, AZ Vesalius, 3700 Tongeren, Belgium
De Schutter, Harlinde; Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Milisen, Koen; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium ; Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium
Flamaing, Johan; Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium ; Gerontology and Geriatrics, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
Kenis, Cindy ; Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium ; Department of Geriatric Medicine, University Hospitals Leuven, 3000 Leuven, Belgium ; Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
Verdoodt, Freija; Research Department, Belgian Cancer Registry, 1210 Brussels, Belgium
Wildiers, Hans ; Department of Oncology, KU Leuven, 3000 Leuven, Belgium ; Department of General Medical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
End-of-Life Care in the Last Three Months before Death in Older Patients with Cancer in Belgium: A Large Retrospective Cohort Study Using Data Linkage.
Publication date :
26 June 2023
Journal title :
Cancers
eISSN :
2072-6694
Publisher :
Multidisciplinary Digital Publishing Institute (MDPI), Switzerland
Volume :
15
Issue :
13
Peer reviewed :
Peer Reviewed verified by ORBi
Funding text :
This research was funded by a grant from Kom op tegen Kanker (‘Stand up to Cancer’, the Flemish Cancer Society). H.W. is a recipient of a grant of the ‘Fonds Voor Wetenschappelijk Onderzoek Vlaanderen’, grant number 1802211N.
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