Abstract 5700
Background
Palliative care units (PCU) have shown an improvement in the quality of life of patients with cancer by reducing overtreatments at the end of life and increasing symptomatic care at home, avoiding unnecessary emergency room visits and decreasing the number of hospital admissions.
Methods
A retrospective observational study was conducted, selecting all patients with a first consultation in the Medical Oncology Unit of the Puerta de Hierro University Hospital (HUPdH) between 2014 and 2015 and died before December 31st 2017. Assessment by PCU, number of hospital admissions and re-admissions and most frequent symptoms for admission in the last 6 months of life were reviewed. The main objective was to know if there were differences between those who were valued by PCU or not.
Results
A total of 662 patients were selected. From them, 86 (13%) patients had never been admitted at HUPdH, 312 (47%) had been admitted once, 169 (26%) twice and 95 (14%) three or more times. Before death, 474 (72%) had been valued by PCU and 302 did not received PCU visit before the second hospital admission episode. The three most frequent causes of admission were deterioration of the general condition, infections and uncontrollable pain. In those with an assessment by PCU before the second admission process, there was a significant decrease in the number of readmissions (25% versus 68%). Moreover, in these patients, there was a statistically significant decrease in the number of re-admissions because of the three main causes of admission but also in others, such as dyspnea, neurological worsening, bleeding and nauseas and vomiting. (Table).Table:
1606P
PCU: Percentage of patients re-admitted with an assessment by palliative care unit by the time of re-admission; Non PCU: Percentage of patients re-admitted without assessment by palliative care units before re-admission | |||
---|---|---|---|
Symptom | PCU | Non PCU | Risk Ratio |
Deterioration of the general condition | 9% | 21% | RR 0.41, 95% CI 0.27-061, p < 0.0001 |
Dyspnea | 3% | 13% | RR 0.24, 95% CI 0.12-0.45, p < 0.0001 |
Neurological worsening | 2% | 8% | RR 0.25, 95% CI 0.11-0.56, p < 0.0001 |
Infections | 5% | 24% | RR 0.20, 95% CI 0.12-0.32, p < 0.0001 |
Uncontrollable pain | 5% | 15% | RR 0.35, 95% CI 0.21-0.59, p < 0.001 |
Nauseas and vomiting | 2% | 7% | RR 0.32, 95% CI 0.14-0.71, p < 0.003 |
Bleeding | 2% | 7% | RR 0.34, 95% CI 0.15-0.75%, p < 0.005 |
Conclusions
In our cohort, in patients with an assessment by PCU before the second admission episode, was observed a decrease in number and severity of re-admissions. An optimization of the symptomatic treatment at home implies a decrease in hospital-acquired or nosocomial complications which leads to a reduction in costs and above all, an improvement in the quality life both of patients and their families.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5751 - Phase 3 ALTA-3 study of brigatinib (BRG) vs alectinib (ALC) in patients (pts) with advanced anaplastic lymphoma kinase (ALK)−positive non–small cell lung cancer (NSCLC) that progressed on crizotinib (CRZ)
Presenter: Sanjay Popat
Session: Poster Display session 1
Resources:
Abstract
5103 - CANOPY phase 3 program: Three studies evaluating canakinumab in patients with non-small cell lung cancer (NSCLC)
Presenter: Luis Paz-Ares
Session: Poster Display session 1
Resources:
Abstract
3666 - The Elderly Patient Individualized Chemotherapy (EPIC) trial, a study for an aged population of non-small cell lung cancer.
Presenter: Francesco Passiglia
Session: Poster Display session 1
Resources:
Abstract
4799 - KEYNOTE-495/KeyImPaCT: A Randomized, Biomarker-Directed, Phase 2 Trial of Pembrolizumab-Based Therapy for Non–Small Cell Lung Cancer (NSCLC)
Presenter: Martin Gutierrez
Session: Poster Display session 1
Resources:
Abstract
6035 - Safety, tolerability and activity of autologous T cells with enhanced T-cell receptors specific to NY ESO 1/LAGE 1a (GSK3377794) alone, or in combination with pembrolizumab, in advanced non small cell lung cancer: A Phase 1b/2a randomised pilot study
Presenter: Karen Reckamp
Session: Poster Display session 1
Resources:
Abstract
2176 - IFCT-1701 DICIPLE: a randomized phase 3 trial comparing continuation Nivolumab-Ipilimumab doublet immunotherapy until progression versus observation in patients with PDL1-positive stage IV Non-Small Cell Lung Cancer (NSCLC) after Nivolumab-Ipilimumab induction treatment
Presenter: Gerard Zalcman
Session: Poster Display session 1
Resources:
Abstract
2352 - ATALANTE-1 randomized phase 3 trial, OSE-2101 versus standard treatment as second or third line in HLA-A2 positive advanced non-small cell lung cancer (NSCLC) patients
Presenter: Enriqueta Felip
Session: Poster Display session 1
Resources:
Abstract
2451 - Phase Ib dose-escalation/expansion study of BI 836880, a VEGF/Ang2-blocking nanobody®, in combination with BI 754091, an anti-PD-1 antibody, in patients with advanced solid tumours
Presenter: Nicolas Girard
Session: Poster Display session 1
Resources:
Abstract
4285 - Radiosurgery followed by Tumor Treating Fields (TTFields) for brain metastases (1-10) from NSCLC in the phase 3 METIS trial
Presenter: Minesh Mehta
Session: Poster Display session 1
Resources:
Abstract
4909 - Nivolumab plus ipilimumab (NI) versus chemotherapy plus nivolumab (CN) in squamous cell lung cancer (SqCLC): the SQUINT trial
Presenter: Lorenza Landi
Session: Poster Display session 1
Resources:
Abstract