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. 2022 Aug;30(8):6795-6805.
doi: 10.1007/s00520-022-07120-4. Epub 2022 May 9.

Disparities in place of death for patients with primary brain tumors and brain metastases in the USA

Rachel F Shenker #  1 , Mary Elizabeth McLaughlin #  2 , Fumiko Chino  3 , Junzo Chino  4
Affiliations

Disparities in place of death for patients with primary brain tumors and brain metastases in the USA

Rachel F Shenker et al. Support Care Cancer. 2022 Aug.

Abstract

Purpose: Patients with primary or metastatic brain tumors often require intensive end-of-life care, for which place of death may serve as a quality metric. Death at home or hospice is considered a more "ideal" location. Comprehensive information on place of death of people with brain tumors is lacking.

Methods: Using CDC Wonder Database data, those who died in the USA from a solid cancer from 2003 to 2016 were included and place of death for those with primary brain, brain metastases, and solid non-brain tumors were compared. Multivariate logistic regression tested for disparities in place of death.

Results: By 2016, 51.1% of patients with primary brain tumors and 45.2% with brain metastases died at home. 15.9% of patients with primary brain tumors and 23.6% with brain metastases died in the hospital. Black patients were least likely to die at home or hospice. For patients with primary brain tumors, being married (OR = 2.25 (95%CI 2.16-2.34), p < 0.01) and having an advanced degree (OR = 1.204 (95%CI 1.15-1.26), p < 0.01) increased odds of home/hospice death; older age (OR = 0.50 (95%CI 0.46-0.54), p < 0.01) decreased odds for home/hospice death. For patients with brain metastases, being married (OR = 2.19 (95%CI 2.11-2.26), p < 0.01) increased odds of home/hospice death and male sex (OR = 0.87 (095%CI .85-0.89), p < 0.01) and older age (OR = 0.59 (95%CI 0.47-0.75), p < 0.01) decreased odds of home/hospice death.

Conclusion: Disparities exist in place of death in the brain tumor population. Focused interventions are indicated to increase the utilization of hospice in those with metastatic cancer, under-represented minority groups, and the elderly population.

Keywords: CNS tumors; Cancer disparities; Health disparities; Palliative care; Place of death.

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References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A (2021) Cancer statistics, 2021. CA Cancer J Clin 71:7–33. https://doi.org/10.3322/caac.21654 - DOI - PubMed
    1. Batchelor TT, Byrne TN (2006) Supportive care of brain tumor patients. Hematol Oncol Clin North Am 20:1337–1361. https://doi.org/10.1016/j.hoc.2006.09.013 - DOI - PubMed
    1. Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, Dahlin CM, Blinderman CD, Jacobsen J, Pirl WF et al (2010) Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med 363:733–742. https://doi.org/10.1056/NEJMoa1000678 - DOI - PubMed
    1. Amano K, Morita T, Tatara R, Katayama H, Uno T, Takagi I (2015) Association between early palliative care referrals, inpatient hospice utilization, and aggressiveness of care at the end of life. J Palliat Med 18:270–273. https://doi.org/10.1089/jpm.2014.0132 - DOI - PubMed
    1. Wright AA, Zhang B, Ray A, Mack JW, Trice E, Balboni T, Mitchell SL, Jackson VA, Block SD, Maciejewski PK et al (2008) Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment. JAMA 300:1665–1673. https://doi.org/10.1001/jama.300.14.1665 - DOI - PubMed - PMC

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