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. 2022 Nov;31(6):e13720.
doi: 10.1111/ecc.13720. Epub 2022 Sep 29.

Hospitalisations of patients with cancer in the last stage of life. Reason to improve advance care planning?

Annemieke van der Padt-Pruijsten  1 , Tanja Oostergo  1 , Maria B L Leys  1 , Carin C D van der Rijt  2   3 , Agnes van der Heide  4
Affiliations

Hospitalisations of patients with cancer in the last stage of life. Reason to improve advance care planning?

Annemieke van der Padt-Pruijsten et al. Eur J Cancer Care (Engl). 2022 Nov.

Abstract

Objective: The aim of this study is to examine why patients are hospitalised in the last stage of life.

Methods: Our study was conducted in a large Dutch teaching hospital. We conducted a retrospective chart review of patients aged ≥18 years who died of cancer either during hospitalisation or after discharge to receive terminal care outside the hospital. We collected data about the characteristics of these hospitalisations and indicators of advance care planning.

Results: Of the 264 deceased patients, 56% had died in the hospital and 44% after hospital discharge. Of all patients, 80% had been admitted to the hospital because of symptom distress. Dyspnoea (39%) and pain (33%) were the most common symptoms. Most patients underwent diagnostic procedures (laboratory tests [97%] and radiology tests [91%]) and received medical treatment (analgesics [71%] and antibiotics [55%]) during their hospitalisation. A 'Do-Not-Resuscitate' code had been recorded before admission in 42% of the patients and in an additional 52% during admission.

Conclusion: Our study shows that patients with cancer in the last stage of life were mainly admitted to the hospital because of symptom distress. Some hospitalisations and in-hospitals deaths may be avoided by more timely recognition of patients' impending death and start of advance care planning.

Keywords: advance care planning; cancer; end-of-life care; hospital care.

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Conflict of interest statement

C. van der Rijt received consulting fees from Kyowa Kirin. The other authors declared no conflicts of interest.

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