Category: Fellows Posters
Purpose: There is an overuse of anti-cancer therapies nearly death, which may lead to adverse events or general worsening and increasing use of health care resources. Health professionals recognize the importance of high-quality end-of-life care. Earle criteria are the most internationally accepted to evaluate aggressiveness at the end-of-life in oncology patients.
The aim of the study is to observe clinical care according to type of tumor in oncology patients at the end of life according to Earle criteria. Other secondary objectives were to describe the end-of-life oncology patient profile and to analyze the association between these patient’s characteristics and aggressive indicators.
An observational, longitudinal and retrospective study was conducted at a tertiary care center. Eligible patients were at least 18 years old, had a diagnosis of solid tumor in treatment with anti-cancer treatment at inclusion time (from August 2015 to July 2016). Patients were followed-up until 31-July 2017 and they were selected if they had death from cancer at this time. Patients with hepatocellular carcinoma were excluded.
We reviewed clinical histories (HCIS®) of the patients included in the study and their electronic prescriptions (Prescriplant®). Data were recorded on REDCap. The variables registered were sociodemographic, clinical, pharmacotherapeutic, date and place of death and health care services provided.
Statistical analysis: mean and standard deviation for normal variables; median and percentiles for non-normal distribution. Categorical variables were expressed as frequencies and percentages. Data were analyzed using STATA® v14.2.
A total of 315 patients were included (mean age: 65.9 years (SD:12.6) and 56.8% males). 91.1% of patients had metastasis and 20.1% registered ECOG≥2. 39.8% had received 3 or more lines of treatment. Lung cancer (21.0%), colo-rectal (15.9%) and breast (10.5%) were most frequent cancers.
87.6% of patients died at hospital in different healthcare services; 50.0% palliative care (PC), 34.78% oncology, 4.71% internal medicine (IM), 2.17% radiation oncology (RO), 0.36% intensive care unit (ICU) and 7.97% others.
71.9% of patients visitted emergency services at least one time. The mean of visits to emergency services last month of life were higher for tumors such as: ovarian (2.2), sarcoma (1.8), bladder (1.5), esophagus and pancreas (1.4) or head and neck, breast, skin-melanoma and lung (1.3).