Abstract:
BACKGROUND:The benefit of palliative chemotherapy (PC) in patients with advanced solid tumors and poor performance status (ECOG-PS) has not been prospectively validated, which makes treatment decision challenging. We aimed to evaluate the overall survival, factors associated with early mortality, and adoption of additional procedures in hospitalized patients with advanced cancer and poor ECOG-PS treated with PC. METHODS:We analyzed a retrospective cohort of patients with advanced cancer treated with PC during hospitalization at an academic cancer center in Brazil from 2014 to 2016. Eligibility criteria included: ECOG-PS 3-4 and start of first-line PC; or ECOG-PS ≥ 2 and start of second or subsequent lines. Primary endpoint was 30-day survival from start of PC. Kaplan-Meier method was used for survival estimates and Cox regression for factors associated with 30-day mortality. RESULTS:Two hundred twenty-eight patients were eligible. 21.9, 66.7 and 11.4% of patients had ECOG-PS 2, 3 and 4, respectively. 49.6% had gastrointestinal tumors. Median follow-up was 49 days (range 1-507). 98.2% of patients had died, 32% during the index hospitalization. The 30-day and 60-day survival rates were 55.7 and 38.5%, respectively. 30% of patients were admitted to the intensive care unit. In a multivariable analysis, ECOG-PS 3/4 (HR 2.01; P = 0.016), hypercalcemia (HR 2.19; P = 0.005), and elevated bilirubin (HR 3.17; P < 0.001) were significantly associated with 30-day mortality. CONCLUSIONS:Patients with advanced cancer and poor ECOG-PS had short survival after treatment with inpatient PC. Inpatient PC was associated with aggressive end-of-life care. Prognostic markers such as ECOG-PS, hypercalcemia and elevated bilirubin can contribute to the decision-making process for these patients.
journal_name
BMC Palliat Carejournal_title
BMC palliative careauthors
Fiorin de Vasconcellos V,Rcc Bonadio R,Avanço G,Negrão MV,Pimenta Riechelmann Rdoi
10.1186/s12904-019-0427-4subject
Has Abstractpub_date
2019-05-20 00:00:00pages
42issue
1issn
1472-684Xpii
10.1186/s12904-019-0427-4journal_volume
18pub_type
杂志文章abstract:BACKGROUND:The use of music as therapy in multidisciplinary end-of-life care dates back to the 1970s and nowadays music therapy (MT) is one of the most frequently used complementary therapy in in-patient palliative care in the US. However existing research investigated music therapy's potential impact mainly from one p...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-018-0286-4
更新日期:2018-02-20 00:00:00
abstract:BACKGROUND:Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the re...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-016-0181-9
更新日期:2017-01-25 00:00:00
abstract:BACKGROUND:Many people with advanced dementia live in residential aged care homes. Care home staff need the knowledge and skills to provide high-quality end-of-life (EOL) dementia care. However, several studies have found EOL dementia care to be suboptimal, and care staff have reported they would benefit from training ...
journal_title:BMC palliative care
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12904-019-0474-x
更新日期:2019-10-23 00:00:00
abstract:BACKGROUND:Most patients with life-limiting illnesses are treated and cared for over a long period of time in primary care and guidelines suggest that ACP discussions should be initiated in primary care. However, a practical model to implement ACP in general practice is lacking. Therefore, the objective of this study i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0091-x
更新日期:2016-02-11 00:00:00
abstract:BACKGROUND:During the last few decades, patients' rights have been reinforced in many countries by acts of law. Measures now include health care proxies to uphold the doctor-patient relationship and advance directives for end-of-life patients. These could be relevant tools as early as the initial diagnosis of haematolo...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-57
更新日期:2014-12-11 00:00:00
abstract:UNLABELLED: BACKGROUND:Parental palliative disease is a family affair, however adolescent's well-being and coping are still rarely considered. The objectives of this paper were a) to identify differences in psychosocial adjustment and health-related quality of life (HRQoL) among adolescents and young adults with paren...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-11-21
更新日期:2012-10-30 00:00:00
abstract:BACKGROUND:To improve the quality of advance care planning (ACP) in primary care, it is important to understand the frequency of and topics involved in the ACP discussion between patients and their family physicians (FPs). METHODS:A secondary analysis of a previous multicenter cross-sectional observational study was p...
journal_title:BMC palliative care
pub_type: 杂志文章,多中心研究
doi:10.1186/s12904-020-00543-y
更新日期:2020-03-17 00:00:00
abstract:BACKGROUND:The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other ...
journal_title:BMC palliative care
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12904-017-0217-9
更新日期:2017-07-10 00:00:00
abstract:BACKGROUND:Current policies recommend integrating home care and palliative care to enable patients to remain at home and avoid unnecessary hospital admission and emergency department (ED) visits. The Italian health care system had implemented integrated palliative home care (IHPC) services to guarantee a comprehensive,...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00626-w
更新日期:2020-08-16 00:00:00
abstract::BACKGROUND: Although guidelines for the care of the dying patient exist the evidence base to support the guidelines is poor. Some of the factors contributing to this include failure to recruit to trials, protective healthcare professionals and subsequent attrition from trials due to the death of the patients. Recent s...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-3-1
更新日期:2004-04-27 00:00:00
abstract:BACKGROUND:Institutional deaths (hospitals and nursing homes) are an important issue because they are often at odds with patient preference and associated with high healthcare costs. The aim of this study was to examine deaths in institutions and the role of individual, regional, and healthcare supply characteristics i...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0156-x
更新日期:2016-09-23 00:00:00
abstract:BACKGROUND:Observational studies investigating risk factors in coronavirus disease 2019 (COVID-19) have not considered the confounding effects of advanced care planning, such that a valid picture of risk for elderly, frail and multi-morbid patients is unknown. We aimed to report ceiling of care and cardiopulmonary resu...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-021-00711-8
更新日期:2021-01-11 00:00:00
abstract:BACKGROUND:Over the past ten years there has been an increasing focus on the need for improving the experience of end of life care. A number of policy initiatives have been introduced to develop approaches to discussing and documenting individual preferences for end of life care, in particular preferred place to die. ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-18
更新日期:2011-11-04 00:00:00
abstract:BACKGROUND:In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of li...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00598-x
更新日期:2020-06-23 00:00:00
abstract:BACKGROUND:Discrepancies between the information that patients have received and the patients' awareness of their condition have frequently been observed in literature and given a number of different explanations. The chief contribution of this study is that by following patients over time it is possible not only to no...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-2
更新日期:2008-02-28 00:00:00
abstract:BACKGROUND:Palliative and end-of-life care development is hindered by a lack of information about the circumstances surrounding dying in developing and resource-poor countries. Our aims were to develop and obtain face and content validity for a self-administered questionnaire on end-of-life care provision and medical d...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00630-0
更新日期:2020-08-14 00:00:00
abstract:BACKGROUND:The Patient Satisfaction Questionnaire (PSQ) is an assessment tool used to evaluate patients' perspectives of their doctor's communication and interpersonal skills. The present pilot study investigated whether the PSQ could be administered successfully in a hospice inpatient setting and if it is an acceptabl...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-13-27
更新日期:2014-06-02 00:00:00
abstract:BACKGROUND:Globally the state of palliative care research remains uncertain. Questions remain regarding impact, funding, and research priorities. Building upon previous research, this review examines palliative care research in Ireland and contributes to a wider international debate on the state of palliative care rese...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-018-0364-7
更新日期:2018-09-27 00:00:00
abstract:BACKGROUND:The supportive hospice aged residential exchange (SHARE) is a new model of palliative care education that has been designed for residential aged care. The goal of SHARE is to help clinical staff improve palliative care within residential aged care facilities and to improve specialist palliative care nurses' ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-020-00633-x
更新日期:2020-08-17 00:00:00
abstract:BACKGROUND:Being a family carer to a patient nearing the end of their life is a challenging and confronting experience. Studies show that caregiving can have negative consequences on the health of family carers including fatigue, sleep problems, depression, anxiety and burnout. One of the goals of palliative care is to...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-9-17
更新日期:2010-08-05 00:00:00
abstract:BACKGROUND:Understanding end of life preferences amongst the oldest old is crucial to informing appropriate palliative and end of life care internationally. However, little has been reported in the academic literature about the end of life preferences of people in advanced age, particularly the preferences of indigenou...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0258-0
更新日期:2017-12-19 00:00:00
abstract:BACKGROUND:The goal of Canada's Compassionate Care Benefit (CCB) is to enable family members and other loved ones who are employed to take a temporary secured leave to care for a terminally ill individual at end of life. Successful applicants of the CCB can receive up to 55% of their average insured earnings, up to a m...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-14
更新日期:2008-08-28 00:00:00
abstract:BACKGROUND:There is a dearth of data regarding the optimal method of detecting and treating depression in palliative care. This study applied the Delphi method to evaluate expert opinion on choice of screening tool, choice of antidepressant and choice of psychological therapy. The aim was to inform the development of b...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-10-10
更新日期:2011-05-27 00:00:00
abstract:BACKGROUND:Even though struggling with similar symptom burden, patients with chronic heart failure (CHF) receive less palliative care than patients suffering from malignant diseases. Researchers have found that this might be related to lack of knowledge about palliative care, insufficient interprofessional communicatio...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-016-0149-9
更新日期:2016-08-15 00:00:00
abstract:BACKGROUND:It has been recognised that more evidence about important aspects of family members' sense of security during palliative care is needed. The objectives of the study was: i) to discover what variables are associated with family members feeling secure during palliative care; ii) to develop a model of family me...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-019-0446-1
更新日期:2019-07-25 00:00:00
abstract:BACKGROUND:One essential element of research is the successful recruitment of participants. However, concerns are obvious regarding the ethical implications of involving terminally ill and even dying patients and their informal caregivers as research participants. This study aims to illustrate central issues encountere...
journal_title:BMC palliative care
pub_type: 杂志文章,多中心研究
doi:10.1186/s12904-015-0020-4
更新日期:2015-05-02 00:00:00
abstract:BACKGROUND:The Palliative Performance Scale (PPS) was first introduced in1996 as a new tool for measurement of performance status in palliative care. PPS has been used in many countries and has been translated into other languages. METHODS:This study evaluated the reliability and validity of PPS. A web-based, case sce...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/1472-684X-7-10
更新日期:2008-08-04 00:00:00
abstract:BACKGROUND:Effective integration between hospices, palliative care services and other local health care services to support patients with palliative care needs is an important international priority. A previous model suggests that integration involves a cumulative stepped process of engagement with other organisations ...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0250-8
更新日期:2017-11-28 00:00:00
abstract:BACKGROUND:Globally, the number of people who die with dementia is increasing. The importance of a palliative approach in the care of people with dementia is recognised and there are national polices to enhance current care. In the UK implementation of these polices is promoted by the National Institute for Health and ...
journal_title:BMC palliative care
pub_type: 杂志文章,评审
doi:10.1186/s12904-015-0047-6
更新日期:2015-10-19 00:00:00
abstract:BACKGROUND:One ambition regarding palliative care is that it should be more accessible to patients and families regardless of care setting. Previous studies show many difficulties and shortcomings in the care of patients with palliative care needs in acute care facilities, but also challenges regarding efforts to imple...
journal_title:BMC palliative care
pub_type: 杂志文章
doi:10.1186/s12904-017-0262-4
更新日期:2017-12-28 00:00:00