Department of Hematology-Oncology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon.
Department of Medical Oncology, Institut Gustave Roussy, Université Paris-Saclay, Gustave Roussy Cancer Campus, F-94805, Villejuif, France.
Support Care Cancer. 2019 Apr;27(4):1529-1533. doi: 10.1007/s00520-018-4543-0. Epub 2018 Nov 7.
Early palliative care is recommended for cancer patients. However, palliative care consults (PCC) are often delayed in Lebanon. The aim of this study was to identify the factors associated with timing of PCC and their impact on the place of death.
This is a retrospective, single institution, study conducted at Hotel Dieu de France University Hospital in Lebanon. The clinical and demographic characteristics of oncology patients who received PCC were obtained. Cox and logistic regression models were used to evaluate the factors determining the time to first PCC and location of death, respectively.
Two hundred and ten patients were included in our analyses with a median age of 69 years (range 22-92 years). The median survival times were: overall survival 18.7 months, time to first PCC 17.9 months, and survival post-PCC 0.6 months. Among patients who were followed-up at home, the median time spent at home was 0.6 months. Late PCC were associated with a childless status (HR = 0.57, 95%CI = 0.37-0.86, p = 0.007), awareness of the diagnosis (HR = 0.64, 95%CI = 0.45-0.91, p = 0.013), and lack of palliative home care (HR = 0.42, 95%CI = 0.25-0.65, p < 0.001). Older patients (OR = 1.03, 95%CI = 1.01-1.05, p = 0.026) and those who had been followed up at home during the PCC (OR = 160.56, 95%CI = 21.39-1205.50, p < 0.001) were significantly more likely to have died at home as opposed to the hospital.
Cancer patients often receive PCC only shortly before their death. PCC for Lebanese cancer patients were found to be significantly delayed in patients that are childless, knowledgeable of their diagnosis, and lack home palliative care.
早期姑息治疗被推荐给癌症患者。然而，在黎巴嫩，姑息治疗咨询（PCC）往往会延迟。本研究的目的是确定与 PCC 时间相关的因素及其对死亡地点的影响。
这是一项在黎巴嫩 Hotel Dieu de France 大学医院进行的回顾性单机构研究。获得接受 PCC 的肿瘤患者的临床和人口统计学特征。使用 Cox 和逻辑回归模型分别评估确定首次 PCC 时间和死亡地点的因素。
我们对 210 名患者进行了分析，中位年龄为 69 岁（范围 22-92 岁）。总生存时间中位数为：总生存时间 18.7 个月，首次 PCC 时间 17.9 个月，PCC 后生存时间 0.6 个月。在家中接受随访的患者中，在家中度过的时间中位数为 0.6 个月。晚期 PCC 与无子女状态（HR=0.57，95%CI=0.37-0.86，p=0.007）、诊断意识（HR=0.64，95%CI=0.45-0.91，p=0.013）和缺乏姑息性家庭护理（HR=0.42，95%CI=0.25-0.65，p<0.001）相关。年龄较大的患者（OR=1.03，95%CI=1.01-1.05，p=0.026）和在 PCC 期间在家中接受随访的患者（OR=160.56，95%CI=21.39-1205.50，p<0.001）更有可能在家中而不是在医院死亡。
癌症患者通常在临终前才接受 PCC。在黎巴嫩的癌症患者中，发现 PCC 明显延迟的患者是那些没有子女、了解自己的诊断和缺乏家庭姑息治疗的患者。
