title: Length of survival of patients with cancer in hospice: a retrospective analysis of patients treated at a major cancer center versus other practice settings.
abstract: This is a retrospective study of the length of survival (LOS) in hospice of patients with cancer treated at a major cancer center compared to other treatment sites. Of 670 patients, the 185 (28%) treated at a major cancer center had unique characteristics, including higher median Palliative Performance Score (PPS) at the time of hospice enrollment (45 versus 40, p = 0.009), and longer median LOS in hospice (35 versus 21 days, p = 0.02: log rank test). Additional variables that predicted longer LOS were higher PPS, Medicare or Medicaid, self-referral, unmarried status, and non-executed advance directives. After adjusting survival for PPS with a Cox proportional hazard model, the hazard ratio for PPS remained statistically significant (95% confidence interval [CI]: 0.95-0.97] while that for the treatment site was not (95% CI: 0.73-1.04]. The performance status, and not the treatment site, was the dominant predictor of the LOS of patients with cancer in hospice.
authors.affiliation: Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada. tallal.younis@cdha.nshealth.ca
authors.forename: Tallal
authors.initials: T
authors.lastname: Younis
authors.forename: Robert
authors.initials: R
authors.lastname: Milch
authors.forename: Nawal
authors.initials: N
authors.lastname: Abul-Khoudoud
authors.forename: David
authors.initials: D
authors.lastname: Lawrence
authors.forename: Amy
authors.initials: A
authors.lastname: Mirand
authors.forename: Ellis G
authors.initials: EG
authors.lastname: Levine
mesh_terms: D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities / Q000145:classification / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006738:Hospices / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D017567:Karnofsky Performance Status; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000401:mortality*; D009518:New York / Q000453:epidemiology; D010166:Palliative Care; D011379:Prognosis; D016016:Proportional Hazards Models; D019984:Quality Indicators, Health Care; D016019:Survival Analysis