Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes

Author:

Baird Andrew1,Nasser Abdullah2,Tanuseputro Peter1345,Webber Colleen345,Wheatley-Price Paul15,Munro Camille15ORCID

Affiliation:

1. Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada

2. Department of Oncology, Western University, London, ON N8W 2X3, Canada

3. Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada

4. ICES, University of Ottawa, Ottawa, ON K1Y 4E9, Canada

5. Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada

Abstract

Malignant pleural mesothelioma is a rare, aggressive, and incurable cancer with a poor prognosis and high symptom burden. For these patients, little is known about the impact of palliative care consultation on outcomes such as mortality, hospital admissions, or emergency department visits. The aim of this study is to determine if referral to supportive and palliative care in patients with malignant pleural mesothelioma is associated with survival and decreased hospital admissions and emergency department visits. This is a retrospective chart review. Study participants include all malignant pleural mesothelioma patients seen at The Ottawa Hospital—an acute care tertiary center—between January 2002 and March 2019. In total, 223 patients were included in the study. The mean age at diagnosis was 72.4 years and 82.5% were male. Of the patients diagnosed between 2002 and 2010, only 11 (9.6%) were referred to palliative care. By comparison, of those diagnosed between 2011 and 2019, 49 (45.4%) were referred to palliative care. Median time from diagnosis to referral was 4.1 months. There was no significant difference in the median survival of patients referred for palliative care compared to those who did not receive palliative care (p = 0.46). We found no association between receiving palliative care and the mean number of hospital admissions (1.04 vs. 0.91) from diagnosis to death, and an increase in mean number of emergency department visits in the palliative care group (2.30 vs. 1.18). Although there was increased utilization of palliative care services, more than half of the MPM patients did not receive palliative care despite their limited survival. There was an increase in emergency department visits in the palliative care group; this may represent an increase in the symptom burden (i.e., indication bias) in those referred to palliative care.

Funder

PSI Graham Farquharson Knowledge Translation Fellowship

Publisher

MDPI AG

Reference21 articles.

1. The Molecular Basis of Malignant Pleural Mesothelioma;Wadowski;Thorac. Surg. Clin.,2020

2. Malignant pleural mesothelioma: An update on investigation, diagnosis and treatment;Bibby;Eur. Respir. Rev.,2016

3. The Mesothelioma Center (2023, April 19). Asbestos and Mesothelioma in Canada. Available online: https://www.asbestos.com/mesothelioma/canada/.

4. Randomized Trials of Systemic Medically-treated Malignant Mesothelioma: A Systematic Review;Blomberg;Anticancer Res.,2015

5. Estimation of the global burden of mesothelioma deaths from incomplete national mortality data;Odgerel;Occup. Environ. Med.,2017

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3