What is different about patients with hematologic malignancies? A retrospective cohort study of cancer patients referred to a hospice research network.

Published

Journal Article

CONTEXT: Although much is known about solid tumor patients who use hospice, the hematologic malignancies hospice population is inadequately described. OBJECTIVES: To compare the characteristics and outcomes of hospice patients with hematologic malignancies to those with solid tumors. METHODS: We extracted electronic patient data (2008-2012) from a large hospice network (Coalition of Hospices Organized to Investigate Comparative Effectiveness) and used bivariate analyses to describe between-group differences. RESULTS: In total, 48,147 patients with cancer were admitted during the study period; 3518 (7.3%) had a hematologic malignancy. These patients had significantly worse Palliative Performance Scale scores (32% vs. 24% were below 40; P < 0.001) and shorter lengths of stay (median 11 vs. 19 days; P < 0.001). They were more likely to die within 24 hours of hospice enrollment (10.9% vs. 6.8%; odds ratio [OR] 1.66; 95% CI 1.49, 1.86; P < 0.001) or within seven days (36% vs. 25.1%; OR 1.68; 95% CI 1.56, 1.81; P < 0.001) and were more likely to receive hospice services in an inpatient or nursing home setting (OR 1.34; 95% CI 1.16, 1.56 and OR 1.54; 95% CI 1.39, 1.72; both P < 0.001). Among hematologic malignancy patients, those with leukemia had the shortest survival (hazard ratio 1.23; 95% CI 1.13, 1.34; P < 0.001), and 40.3% used hospice for less than seven days (OR 1.31; 95% CI 1.11, 1.56; P = 0.002). CONCLUSION: Hospice patients with hematologic malignancies are more seriously ill at the time of admission, with worse functional status and shorter lengths of stay than other cancer patients. Differences in outcomes suggest the need for targeted interventions to optimize hospice services for the hematologic malignancies population, especially those with leukemia.

Full Text

Duke Authors

Cited Authors

  • LeBlanc, TW; Abernethy, AP; Casarett, DJ

Published Date

  • March 2015

Published In

Volume / Issue

  • 49 / 3

Start / End Page

  • 505 - 512

PubMed ID

  • 25116911

Pubmed Central ID

  • 25116911

Electronic International Standard Serial Number (EISSN)

  • 1873-6513

Digital Object Identifier (DOI)

  • 10.1016/j.jpainsymman.2014.07.003

Language

  • eng

Conference Location

  • United States