Survival duration among patients with a noncancer diagnosis admitted to a palliative care unit: a retrospective study

Title

Survival duration among patients with a noncancer diagnosis admitted to a palliative care unit: a retrospective study

Creator

Downar J; Chou Yang-Chieh; Ouellet D; La Delfa Ignazio; Blacker S; Bennett M; Petch C; Cheng SM

Publisher

Journal Of Palliative Medicine

Date

2012

Subject

Female; Humans; Male; retrospective studies; Palliative Care; Terminally Ill; Adult; Prognosis; Medical Audit; Aged; Middle Aged; Length of Stay; Ontario; Survival Analysis; Regression Analysis; 80 and over

Description

BACKGROUND: Palliative care unit (PCU) beds are a limited resource in Canada, so PCU admission is restricted to patients with a short prognosis. Anecdotally, PCUs further restrict admission of patients with noncancer diagnoses out of fear that they will "oversurvive" and reduce bed availability. This raises concerns that noncancer patients have unequal access to PCU resources. PURPOSE/METHODS: To clarify survival duration of patients with a noncancer diagnosis, we conducted a retrospective review of all admissions to four PCUs in Toronto, Canada, over a 1-year period. We measured associations between demographic data, prognosis, Palliative Performance Score (PPS), length of stay (LOS), and waiting time. RESULTS: We collected data for 1000 patients, of whom 21% had noncancer diagnoses. Noncancer patients were older, with shorter prognoses and lower PPS scores on admission. Noncancer patients had shorter LOS (14 versus 24, p<0.001) than cancer patients and a similar likelihood of being discharged alive to cancer patients. Noncancer patients had a trend to lower LOS across a broad range of demographic, diagnostic, prognostic, and PPS categories. Multivariable analysis showed that LOS was not associated with the diagnosis of cancer (p=0.36). DISCUSSION/CONCLUSION: Noncancer patients have a shorter LOS than cancer patients and a similar likelihood of being discharged alive from a PCU than cancer patients, and the diagnosis of cancer did not correlate with survival in our study population. Our findings demonstrate that noncancer patients are not "oversurviving," and that referring physicians and PCUs should not reject or restrict noncancer referrals out of concern that these patients are having a detrimental impact on PCU bed availability.

Rights

Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).

Type

Journal Article

Citation List Month

Backlog

Pages

661-666

Issue

6

Volume

15

Citation

Downar J; Chou Yang-Chieh; Ouellet D; La Delfa Ignazio; Blacker S; Bennett M; Petch C; Cheng SM, “Survival duration among patients with a noncancer diagnosis admitted to a palliative care unit: a retrospective study,” Pediatric Palliative Care Library, accessed September 26, 2021, https://pedpalascnetlibrary.omeka.net/items/show/11467.

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