晚期非小细胞肺癌患者在家中或临终关怀机构与在医院死亡的回顾性预后研究

Retrospective Prognostic Study of Death at Home or Hospice Versus at a Hospital Among Patients With Advanced Non-Small Cell Lung Cancer.

作者信息

Hamamoto Yoichiro, Ibe Tatsuya, Kodama Hiroaki, Mouri Atsuto, Mineshita Masamichi

机构信息

Department of Pulmonary Medicine, Nishisaitama-Chuo National Hospital, Wakasa, Tokorozawa city, Saitama, Japan.

Department of Pulmonary Medicine, Saitama Medical University International Medical Center, Yamane, Hidaka-city, Saitama, Japan.

出版信息

Am J Hosp Palliat Care. 2020 Feb;37(2):129-135. doi: 10.1177/1049909119865865. Epub 2019 Jul 31.

DOI:10.1177/1049909119865865

PMID:31366208

Abstract

BACKGROUND

Patients with advanced non-small cell lung cancer greatly care about where they will die. Most people in Japan preferred their location of death as their homes. But only 8.2% of patients with cancer spend their last days at home with palliative care in Japan. Many patients with cancer are still going to spend their last days at a hospital (81.7%).

OBJECTIVE

We examined the survival times of such patients according to their place of death; that is, whether they died at home, at a hospice, or at a hospital, and investigated patient characteristics.

RESULTS

Among the 313 patients recruited, 214 were analyzed in this study: 90, 49, and 75 received hospital-based, home-based, and hospice-based palliative care, respectively. The patients who died at a hospice exhibited significantly longer survival than those who died at hospital (estimated median survival time, 420 days [95% confidence interval [CI]: 325-612 days] versus 252 days [95% CI: 201-316 days]; < .0001). The characteristics of patients did not differ significantly according to place of death.

CONCLUSIONS

Patients who died at a hospice or at home exhibited significantly longer survival than those who died at a hospital for advanced non-small cell lung cancer.

摘要

背景

晚期非小细胞肺癌患者非常在意自己的死亡地点。在日本，大多数人希望在家中离世。但在日本，只有8.2%的癌症患者在接受姑息治疗的情况下在家中度过最后时光。许多癌症患者仍在医院度过他们的最后日子（81.7%）。

目的

我们根据患者的死亡地点，即他们是在家中、临终关怀机构还是医院死亡，来研究这些患者的生存时间，并调查患者特征。

结果

在招募的313名患者中，本研究分析了214名：分别有90名、49名和75名患者接受了基于医院、家庭和临终关怀机构的姑息治疗。在临终关怀机构死亡的患者的生存期明显长于在医院死亡的患者（估计中位生存时间，420天[95%置信区间[CI]：325 - 612天]对252天[95% CI：201 - 316天]；<0.0001）。患者特征根据死亡地点没有显著差异。