title: The characteristics of advanced cancer patients followed at home, but admitted to the hospital for the last days of life.
abstract: Information regarding advanced cancer patients followed at home who are admitted to the hospital in the last days of life are lacking. The aim of this study was to assess the characteristics of patients who were hospitalized in the last days of life after being assisted by a home palliative care team. The secondary outcome was to identify possible risk factors for hospitalization. The charts were analyzed of a consecutive sample of advanced cancer patients admitted to hospital wards in the last days of life after being followed at home by a palliative care team. Of 550 consecutive patients followed at home, 138 (25.1 %) were admitted to the hospital. Younger patients were more likely to die in the hospital. In a logistic risk analysis adjusted for age, patients with lung and head-neck cancer were more likely to die in the hospital. Patients having a female relative or a female consort as a caregiver were more likely to die at home. CAGE-positive patients (7.25 %), and patients with a shorter period of home assistance were more likely transported to hospital before dying (p = 0.00 and p < 0.024, respectively). The most frequent reason for hospital admission was dyspnea. Admission was more frequent to the oncology ward. Patients who were admitted to the hospital died after a mean of 10.2 days (SD 8.2, range 0-40). This study provides preliminary data on the risk factors of hospitalization at the end of life for advanced cancer patients followed at home.
authors.affiliation: Anesthesia and Intensive Care and Pain Relief and Supportive Care, La Maddalena Cancer Center and University of Palermo, Via San Lorenzo 312, 90146, Palermo, Italy. terapiadeldolore@lamaddalenanet.it.
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.affiliation: Section of Clinical Epidemiology and Environmental Medicine, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Masedu
authors.affiliation: Section of Clinical Epidemiology and Environmental Medicine, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Valenti
authors.affiliation: University of L' Aquila, L'Aquila, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mercadante
authors.affiliation: "L'Aquila per la Vita" Home Care Unit and Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Aielli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000145:classification* / Q000706:statistics & numerical data
keywords: Advanced cancer; Death; End of life; Home care; Palliative care