title: Inpatient hospitalization of oncology patients: are we missing an opportunity for end-of-life care?
abstract: BACKGROUND
  Despite advances in the care of patients with cancer over the last 10 years, cancer remains the second leading cause of death in the United States. Many patients receive aggressive, in-hospital end-of-life care at high cost. There are few data on outcomes after unplanned hospitalization of patients with metastatic cancer.
  
  
  METHODS
  In 2000 and 2010, data were collected on admissions, interventions, and survival for patients admitted to an academic inpatient medical oncology service.
  
  
  RESULTS
  The 2000 survey included 191 admissions of 151 unique patients. The 2010 survey assessed 149 admissions of 119 patients. Lung, GI, and breast cancers were the most common cancer diagnoses. In the 2010 assessment, pain was the most common chief complaint, accounting for 28%. Although symptoms were the dominant reason for admission in 2010, procedures and imaging were common in both surveys. The median survival of patients after discharge was 4.7 months in 2000 and 3.4 months in 2010. Despite poor survival in this patient population, hospice was recommended in only 23% and 24% of patients in 2000 and 2010, respectively. Seventy percent of patients were discharged home without additional services.
  
  
  CONCLUSIONS
  On the basis of our data, an unscheduled hospitalization for a patient with advanced cancer strongly predicts a median survival of fewer than 6 months. We believe that hospital admission represents an opportunity to commence and/or consolidate appropriate palliative care services and end-of-life care.
authors: University of Wisconsin, Carbone Cancer Center, Hematology/Oncology, K6/518, 600 Highland Ave, Madison, WI 53729, USA. grocque@uwhealth.org
authors: Gabrielle B
authors: GB
authors: Rocque
authors: Anne E
authors: AE
authors: Barnett
authors: Lisa C
authors: LC
authors: Illig
authors: Jens C
authors: JC
authors: Eickhoff
authors: Howard H
authors: HH
authors: Bailey
authors: Toby C
authors: TC
authors: Campbell
authors: James A
authors: JA
authors: Stewart
authors: James F
authors: JF
authors: Cleary
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities / Q000706:statistics & numerical data*; D003625:Data Collection; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms; D010166:Palliative Care; D010820:Physicians / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D013727:Terminal Care
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