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Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma.

Frequency and Predictors of Acute Hospitalization Before Death in Patients With Glioblastoma.

Title
Publication TypeJournal Article
Year of Publication2017
AuthorsDiamond EL, Panageas KS, Dallara A, Pollock A, Applebaum AJ, Carver AC, Pentsova E, DeAngelis LM, Prigerson HG
JournalJ Pain Symptom Manage
Volume53
Issue2
Pagination257-264
Date Published2017 02
ISSN1873-6513
KeywordsBrain Neoplasms, Case-Control Studies, Critical Care, Female, Glioblastoma, Hospitalization, Humans, Male, Middle Aged, Quality of Life, Retrospective Studies, Terminal Care
Abstract

CONTEXT: Glioblastoma (GBM) is a devastating and incurable neuro-oncologic disease, and issues related to the end of life are almost invariably a matter of "when," not a matter of "if." Optimizing symptom management and quality of life in later stages of disease is of the utmost priority.

OBJECTIVES: To examine the frequency of and factors associated with late acute hospital admission before death in patients with GBM.

METHODS: Case-control study comparing patients with GBM admitted to the hospital within one month of death to those without late hospital admission.

RESULTS: Of 385 GBM patients followed to death at Memorial Sloan Kettering Cancer Center, 164 (42.6%) were admitted within a month of death, most frequently (140, or 85%) to manage neurologic decline. Of these, 56 (34%) had intensive care unit care during this admission and 22 (13%), 18 (11%), and 2 (1%) received mechanical ventilation, enteral feeding tubes, or cardiopulmonary resuscitation, respectively. In multivariable analysis, in-hospital chaplaincy consultation, and participation in a therapeutic clinical trial, both at any time in the GBM disease course, were significantly associated with late hospital admission.

CONCLUSIONS: Late hospitalization is frequent in GBM and often involves intensive care unit care in the management of clinical events that are part of the GBM dying process. Patients with a tendency to use religious support and those enrolled in clinical trials may be at greater risk for late hospitalization. Dedicated prospective study is needed to determine predictors of late hospitalization and to examine the impact of late acute medical care on quality of life in GBM.

DOI10.1016/j.jpainsymman.2016.09.008
Alternate JournalJ Pain Symptom Manage
PubMed ID27810565
PubMed Central IDPMC5253315
Grant ListP30 CA008748 / CA / NCI NIH HHS / United States
R35 CA197730 / CA / NCI NIH HHS / United States

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