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
4883 - A New Population Model Validated Pharmacokinetic Similarity of HLX01 and Rituximab in B-Cell Lymphoma
Presenter: Yuankai Shi
Session: Poster Display session 1
Resources:
Abstract
4908 - Efficacy of salvage therapy in the treatment of Helicobacter pylori-positive gastric low-grade mucosa-associated lymphoid tissue lymphoma
Presenter: Sung-Nam Lim
Session: Poster Display session 1
Resources:
Abstract
2360 - Mutational analysis of extranodal marginal zone lymphoma using next generation sequencing
Presenter: Seok Jae Huh
Session: Poster Display session 1
Resources:
Abstract
2430 - Clinical features, treatment and outcomes of colon and rectum mucosa-associated lymphoid tissue (MALT) lymphoma: Literature reviews published in English between 1993 and 2017
Presenter: Jeong Yeon Kim
Session: Poster Display session 1
Resources:
Abstract
4654 - Splenic marginal zone lymphoma: clinical characteristics and prognostic factors in a series of 52 patients
Presenter: Guldane Cengiz Seval
Session: Poster Display session 1
Resources:
Abstract
1732 - Safety and efficacy of Bendamustine and Rituximab (BR) regimen in Indian Chronic Lymphocytic Leukemia patients
Presenter: Ajay Gogia
Session: Poster Display session 1
Resources:
Abstract
5784 - N-terminal B-type natriuretic peptide (NT-proBNP) as an independed prognostic marker for patients with newly diagnosed multiple myeloma complicated by dialysis-dependent renal failure
Presenter: Sergey Semochkin
Session: Poster Display session 1
Resources:
Abstract
836 - The first-line effect of Bortezomib-based Therapy on Clinical Outcomes for Taiwanese Patients with multiple myeloma
Presenter: Ching-Liang Ho
Session: Poster Display session 1
Resources:
Abstract
2085 - Impact of Donor Lymphocyte Infusion in Relapsing Myeloid Neoplasms Post Allogeneic Hematopoietic Stem Cell Transplantation
Presenter: Hanafy Hafez
Session: Poster Display session 1
Resources:
Abstract
6079 - Invasive fungal diseases in patients with Hodgkin’s lymphoma before and after allogeneic hematopoietic stem cell transplantation
Presenter: Marina Popova
Session: Poster Display session 1
Resources:
Abstract