Frequency and predictors of acute hospitalization before death in patients with glioblastoma Journal Article
| Authors: | Diamond, E. L.; Panageas, K. S.; Dallara, A.; Pollock, A.; Applebaum, A. J.; Carver, A. C.; Pentsova, E.; DeAngelis, L. M.; Prigerson, H. G. |
| Article Title: | Frequency and predictors of acute hospitalization before death in patients with glioblastoma |
| Abstract: | Context Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life are almost invariably a matter of “when,” not a matter of “if.” Optimizing symptom management and quality of life in later stages of disease is of the utmost priority. Objectives To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM. Methods Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission. Results Of 385 GBM patients followed to death at Memorial Sloan Kettering Cancer Center, 164 (42.6%) were admitted within a month of death, most frequently (140, or 85%) to manage neurologic decline. Of these, 56 (34%) had intensive care unit care during this admission and 22 (13%), 18 (11%), and 2 (1%) received mechanical ventilation, enteral feeding tubes, or cardiopulmonary resuscitation, respectively. In multivariable analysis, in-hospital chaplaincy consultation, and participation in a therapeutic clinical trial, both at any time in the GBM disease course, were significantly associated with late hospital admission. Conclusions Late hospitalization is frequent in GBM and often involves intensive care unit care in the management of clinical events that are part of the GBM dying process. Patients with a tendency to use religious support and those enrolled in clinical trials may be at greater risk for late hospitalization. Dedicated prospective study is needed to determine predictors of late hospitalization and to examine the impact of late acute medical care on quality of life in GBM. © 2016 American Academy of Hospice and Palliative Medicine |
| Keywords: | palliative care; quality of life; glioblastoma; malignant brain tumor |
| Journal Title: | Journal of Pain and Symptom Management |
| Volume: | 53 |
| Issue: | 2 |
| ISSN: | 0885-3924 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2017-02-01 |
| Start Page: | 257 |
| End Page: | 264 |
| Language: | English |
| DOI: | 10.1016/j.jpainsymman.2016.09.008 |
| PROVIDER: | scopus |
| PUBMED: | 27810565 |
| PMCID: | PMC5253315 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 February 2017 -- Source: Scopus |
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