title: Association between the duration of palliative care service and survival in terminal cancer patients.
abstract: OBJECTIVE
  Preliminary studies of early palliative care showed improved quality of life, less medical cost, and better survival time. But, most terminal cancer patients tend to be referred to palliative care late. For the proper care of terminal cancer patients, it is necessary to refer to hospice and palliative care timely. The aim of this study is to analyze the effect of the duration of palliative care services on the survival in terminal cancer patients.
  
  
  METHODS
  We reviewed 609 patients who had died from terminal cancer between January 2010 and December 2012. We analyzed correlations of age, first Palliative Performance Scale (PPS) level, duration of palliative care service, and survival time. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival.
  
  
  RESULTS
  Duration of palliative care services was significantly correlated with survival time. In univariate Cox regression analysis, age, and each group of duration of palliative care service showed significant associations with survival. Final multivariate Cox regression model retained four parameters as independent prognostic factors for survival (age HR = 0.99 (p = 0.002), 1∼10 days HR = 2.64 (p < 0.001), 11∼30 days HR = 2.43 (p < 0.001), 31∼90 days HR = 1.87 (p < 0.001)).
  
  
  CONCLUSIONS
  Shorter duration of palliative care services showed poor prognostic factor. Timely referral system from the end of chemotherapy is warranted.
authors.affiliation: College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 137-701, Republic of Korea.
authors.forename: Yong Joo
authors.initials: YJ
authors.lastname: Lee
authors.forename: Jung-Hwa
authors.initials: JH
authors.lastname: Yang
authors.forename: Jung-Wook
authors.initials: JW
authors.lastname: Lee
authors.forename: Johi
authors.initials: J
authors.lastname: Yoon
authors.forename: Jung-Ran
authors.initials: JR
authors.lastname: Nah
authors.forename: Whan-Seok
authors.initials: WS
authors.lastname: Choi
authors.forename: Chul-Min
authors.initials: CM
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D061345:Early Medical Intervention / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D016016:Proportional Hazards Models; D011788:Quality of Life; D012017:Referral and Consultation; D017741:Survivors / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000379:methods*; D013997:Time Factors