Abstract 1266P
Background
Little is known about the number of hospitalized cancer patients with a limited life expectancy. Moreover, there is scarce information regarding involvement of specialist palliative care teams (PCT) among hospital inpatients.This study aimed to investigate how many patients with a probable limited life expectancy were hospitalized in Dutch hospitals on a given day, whether a PCT was involved or if involvement was considered desirable.
Methods
A flash mob study was conducted in Dutch hospitals on the 16th of April 2021. For all hospital inpatients, physicians and nurses independently answered the surprise question (SQ): “Would you be surprised if this patient died within the next 12 months?”. If the answer was ‘no’ they were asked to indicate if they estimated life expectancy to be less than 3 months and whether PCTs were involved. We here report a subgroup analysis for hospital inpatients with haematological and solid cancer.
Results
Forty-eight out of 68 hospitals in the Netherlands participated in this study (71%). Surveys were completed for 1693 patients with cancer. The SQ was negatively answered in 49% of patients by physicians and 47% by nurses, respectively. Agreement between physicians and nurses was moderate (κ=0.49). Life expectancy was estimated to be less than 3 months in 13.4% and 12.2% of patients by physicians and nurses, respectively (κ= 0.56). Treatment limitations were registered in 37.7% of all patients, increasing to 58.1% and 75.5% of patients with an estimated life expectancy of less than 12 months or less than 3 months, respectively. The PCT was involved in 6.3%of patients, and involvement was desirable in 4.9% according to physicians, increasing to 26.0% and 14.8% when life expectancy was estimated to be less than 3 months.
Conclusions
In almost half of the hospital inpatients with cancer, the SQ was answered negatively, suggesting a limited life expectancy and possible palliative care needs. PCTs were involved in only a small proportion of these patients, suggesting a possible lack of timely palliative care. Further studies should focus on exploration of palliative care needs of hospital inpatients, ways to improve identification of patients with a limited life expectancy for all healthcare providers and strategies to timely start palliative care.
Clinical trial identification
NL9184.
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.