ORIGINAL RESEARCH ARTICLE
Factors Affecting Mortality at Home and Hospital in Oncology Patients and the Effect of Age
Received Date : 22 Oct 2023
Accepted Date : 23 Feb 2024
Available Online : 15 Mar 2024
Sema YILMAZ RAKICIa, Özlem TERZİb, Songül ÖZYURTc, Zihni Acar YAZICId
aRecep Tayyip Erdoğan University Faculty of Medicine, Department of Radiation Oncology, Rize, Türkiye
bOndokuz Mayıs University Faculty of Medicine, Department of Public Health, Samsun, Türkiye
cRecep Tayyip Erdoğan University Faculty of Medicine, Department of Chest Diseases, Rize, Türkiye
dRecep Tayyip Erdoğan University Faculty of Medicine, Clinical Microbiology Department, Rize, Türkiye
Doi: 10.37047/jos.2023-99971 - Article's Language: EN
Journal of Oncological Sciences. 2024;10(2):73-81.
ABSTRACT
Objective: Several factors assessing cancer mortality and impacting the choice of place of death for terminally ill patients have been
previously documented. We examined the relationships between several oncological factors, including age, on cancer mortality and the choice
of place of death. Material and Methods: All patient data were collected retrospectively from hospital computer records and medical chart reviews.
A total of 2,183 patients admitted to our hospital over 6 years (September 2013-December 2019) were included. Results: A total of 2,183
patients were analyzed, of which 58.5% (n=1,277) of patients died. More deaths occurred in the hospital than at home (n=1,032 vs. n=245). The
mean age of patients who died at home was more than those who died in the hospital (mean ages: 68.4±12.5 vs. 63.5±12.5; median ages: 69, range
24-100 vs. 63, range 19-97). The hospital mortality rate of patients <65 years old was statistically higher than patients ≥65 years old. Conclusion:
We found that a second primary cancer, metastasis, diagnosis from the primary mass, certain cancer diagnoses (such as lungs, stomach, and
brain cancers), locally advanced and metastatic stage cancers, certain histological types, late diagnosis (the first application to branches such as
chest diseases, emergency, neurosurgery) negatively affected mortality. In addition, we determined that metastatic, locally advanced stage. and
patients aged <65 years of age died more frequently in the hospital.
Keywords: Cancer mortality; home care; hospital palliative supportive treatment; home health services
REFERENCES
- Chhikara BS, Parang K. Global Cancer Statistics 2022: the trends projection analysis. Chemical Biology Letters. 2023;10(1):451-467. [Link]
- Beccaro M, Costantini M, Giorgi Rossi P, Miccinesi G, Grimaldi M, Bruzzi P; ISDOC Study Group. Actual and preferred place of death of cancer patients. Results from the Italian survey of the dying of cancer (ISDOC). J Epidemiol Community Health. 2006;60(5):412-416. [Crossref] [PubMed] [PMC]
- Tang ST, McCorkle R. Determinants of place of death for terminal cancer patients. Cancer Invest. 2001;19(2):165-180. [Crossref] [PubMed]
- Alonso-Babarro A, Bruera E, Varela-Cerdeira M, et al. Can this patient be discharged home? Factors associated with at-home death among patients with cancer. J Clin Oncol. 2011;29(9):1159-1167. [Crossref] [PubMed] [PMC]
- Vidal M, Rodriguez-Nunez A, Hui D, et al. Place-of-death preferences among patients with cancer and family caregivers in inpatient and outpatient palliative care. BMJ Support Palliat Care. 2022;12(e4):e501-e504. [Crossref] [PubMed]
- Abarshi E, Onwuteaka-Philipsen B, Donker G, Echteld M, Van den Block L, Deliens L. General practitioner awareness of preferred place of death and correlates of dying in a preferred place: a nationwide mortality follow-back study in the Netherlands. J Pain Symptom Manage. 2009;38(4):568-577. [Crossref] [PubMed]
- Hashim D, Boffetta P, La Vecchia C, et al. The global decrease in cancer mortality: trends and disparities. Ann Oncol. 2016;27(5):926-933. [Crossref] [PubMed]
- Jong-wook L. Global health improvement and WHO: shaping the future. Lancet. 2003;362(9401):2083-2088. [Crossref] [PubMed] [PMC]
- Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136(5):E359-86. [Crossref] [PubMed]
- Coleman MP, Estève J, Damiecki P, Arslan A, Renard H. Trends in cancer incidence and mortality. IARC Sci Publ. 1993;(121):1-806. [PubMed]
- Tang ST, Chen ML, Huang EW, Koong SL, Lin GL, Hsiao SC. Hospice utilization in Taiwan by cancer patients who died between 2000 and 2004. J Pain Symptom Manage. 2007;33(4):446-453. [Crossref] [PubMed]
- Grande GE, Addington-Hall JM, Todd CJ. Place of death and access to home care services: are certain patient groups at a disadvantage? Soc Sci Med. 1998;47(5):565-579. [Crossref] [PubMed]
- Tang ST. When death is imminent: where terminally ill patients with cancer prefer to die and why. Cancer Nurs. 2003;26(3):245-251. [Crossref] [PubMed]
- Emanuel EJ, Emanuel LL. The promise of a good death. Lancet. 1998 May;351 Suppl 2:SII21-9. [Crossref] [PubMed]
- Simoens S, Kutten B, Keirse E, et al. The costs of treating terminal patients. J Pain Symptom Manage. 2010;40(3):436-448. [Crossref] [PubMed]
- Townsend J, Frank AO, Fermont D, et al. Terminal cancer care and patients' preference for place of death: a prospective study. BMJ. 1990;301(6749):415-417. [Crossref] [PubMed] [PMC]
- Rakici SY, Terzi O. Oncology mortality: weekend and summer vacation effect. BMJ Support Palliat Care. 2023 Apr:spcare-2022-004143. [PubMed]
- Bengtson VL, Cuellar JB, Ragan PK. Stratum contrasts and similarities in attitudes toward death. J Gerontol. 1977;32(1):76-88. [Crossref] [PubMed]
- Richard Kalish. Death and Ethnicity. A Psychocultural Study. Edition 1st Edition, First Published 1976. eBook Published 2019. New York. Imprint Routledge. Pages 230. [Crossref]
- Hsu HC, Hu WY, Chuang RB, Chiu TY, chen CY. [Symptoms in the elderly with terminal cancer-a study in Taiwan]. Formosan J Med. 2002;6:465-473. [Link]
- Tsai JS, Wu CH, Chiu TY, Hu WY, Chen CY. Fear of death and good death among the young and elderly with terminal cancers in Taiwan. J Pain Symptom Manage. 2005;29(4):344-351. [Crossref] [PubMed]
- Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733-742. [Crossref] [PubMed]
- Salins N, Ramanjulu R, Patra L, Deodhar J, Muckaden MA. Integration of early specialist palliative care in cancer care and patient related outcomes: a critical review of evidence. Indian J Palliat Care. 2016;22(3):252-257. [Crossref] [PubMed] [PMC]
- Kavşur Z, Sevimli E. [The comparison palliative care services of Turkey with some developed countries]. International Journal of Social Sciences Academy. 2020;2(4):715-730. [Crossref]
- Bowles KH, McCorkle R, Nuamah IF. Homecare referrals and 12-week outcomes following surgery for cancer. Oncol Nurs Forum. 2008;35(3):377-383. [Crossref] [PubMed] [PMC]
- Hirabayashi Y, Miyashita M, Kawa M, Kazuma K, Yamashita K, Okamoto N. Factors relating to terminally ill cancer patients' willingness to continue living at home during the early phase of home care after discharge from clinical cancer centers in Japan. Palliat Support Care. 2007;5(1):19-30. [Crossref] [PubMed]
- Colditz GA, Sellers TA, Trapido E. Epidemiology - identifying the causes and preventability of cancer? Nat Rev Cancer. 2006;6(1):75-83. [Crossref] [PubMed]
- Wingo PA, Cardinez CJ, Landis SH, et al. Long-term trends in cancer mortality in the United States, 1930-1998. Cancer. 2003;97(S12):3133-3275. Erratum in: Cancer. 2005;103:2658. [Crossref] [PubMed]
- Efficace F, Collins GS, Cottone F, et al. Patient-reported outcomes as independent prognostic factors for survival in oncology: systematic review and meta-analysis. Value Health. 2021;24(2):250-267. [Crossref] [PubMed]
- Lv M, Zhang X, Shen Y, et al Clinical analysis and prognosis of synchronous and metachronous multiple primary malignant tumors. Medicine (Baltimore). 2017;96(17):e6799. [Crossref] [PubMed] [PMC]
- Hanna TP, King WD, Thibodeau S, et al. Mortality due to cancer treatment delay: systematic review and meta-analysis. BMJ. 2020 Nov;371:m4087. [Crossref] [PubMed] [PMC]