title: Palliative care needs in COPD patients with or without cancer: an epidemiological study.
abstract: Chronic obstructive pulmonary disease (COPD) is a growing cause of morbidity and mortality worldwide. However, many patients with severe COPD do not receive adequate palliative care. The main goals of our study were to identify the percentage of hospital patients with palliative care needs, particularly those who suffer from COPD.Data were collected prospectively from inpatients at the University Medical Centre Freiburg (Freiburg, Germany). Based on the World Health Organization definition of palliative care, the treating physician reported for each patient discharged whether the patient had palliative care needs or not. Data from 39 849 patients could be analysed, of which 1455 were suffering from COPD.Of all COPD patients, 9.1% had palliative care needs. In COPD patients with palliative care needs, hospital stay was significantly longer (13.7 versus 10.3 days) than in the group without palliative care needs, and significantly more patients died during their hospital stay (8.3% versus 3.7%). The presence of metastases was the highest risk factor for developing palliative care needs (OR 4.18). Furthermore, a main diagnosis of COPD implied an increased probability of palliative care needs (OR 1.87).Our results show that COPD patients have a high risk of developing palliative care needs. Further efforts are required to provide palliative care to COPD patients.
authors.affiliation: Department of Palliative Care, University Medical Centre Freiburg, Freiburg, Germany.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Meffert
authors.affiliation: Department of Anaesthesiology, Intensive Care and Pain Therapy, St. Vincent Hospital,  Landau, Germany.
authors.forename: Isaak
authors.initials: I
authors.lastname: Hatami
authors.affiliation: Department of Palliative Care, University Medical Centre Freiburg, Freiburg, Germany.
authors.forename: Carola
authors.initials: C
authors.lastname: Xander
authors.affiliation: Department of Palliative Care, University Medical Centre Freiburg, Freiburg, Germany gerhild.becker@uniklinik-freiburg.de.
authors.forename: Gerhild
authors.initials: G
authors.lastname: Becker
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D015897:Comorbidity; D016001:Confidence Intervals; D016021:Epidemiologic Studies; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006301:Health Services Needs and Demand; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D010166:Palliative Care / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016019:Survival Analysis; D016896:Treatment Outcome