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.

Abstract

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.

• Authors: Victoria Depoorter, Katrijn Vanschoenbeek, Lore Decoster, Geert Silversmit, Philip R Debruyne, Inge De Groof, Dominique Bron, Frank Cornélis, Sylvie Luce, Christian Focan, Vincent Verschaeve, Gwenaëlle Debugne, Christine Langenaeken, Heidi Van Den Bulck, Jean-Charles Goeminne, Wesley Teurfs, Guy Jerusalem, Dirk Schrijvers, Bénédicte Petit, Marika Rasschaert, Jean-Philippe Praet, Katherine Vandenborre, Harlinde De Schutter, Koen Milisen, Johan Flamaing, Cindy Kenis, Freija Verdoodt, Hans Wildiers
• Journal: Cancers (Cancers (Basel)) Vol. 15 Issue 13 (Jun 26 2023) ISSN: 2072-6694 [Print] Switzerland
• PMID: 37444458 (Publication Type: Journal Article)