Department of Surgery, Division of Surgical Oncology, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, 395 W. 12th Ave., Suite 670, Columbus, OH, 43210, USA.
Division of Medical Oncology, Medical Director, Supportive Care Services, James Comprehensive Cancer Center, The Ohio State University Wexner Medical Center, 1250 Lincoln Tower, Columbus, OH, 43210, USA.
J Gastrointest Surg. 2021 Jan;25(1):155-161. doi: 10.1007/s11605-020-04568-9. Epub 2020 Mar 19.
We sought to define the incidence and characterize the timing of hospice utilization among racial/ethnic minority patients following pancreatectomy for pancreatic cancer.
The Medicare Standard Analytic Files from 2013 to 2017 were used to identify patients with pancreatic cancer who underwent a pancreatectomy. Logistic regression was utilized to identify the association between race and patterns of hospice utilization among deceased individuals.
Among the 14,495 individuals (median age 73; 52.3% female; 6.8% racial/ethnic minority) who underwent a pancreatectomy for pancreatic cancer, 47% (n = 6859) died by the end of the follow-period. Among deceased individuals, three-fourths of patients (n = 4978, 72.6%) used hospice leading up to the time of death. Racial/ethnic minority patients were less likely, however, to have used hospice services compared with white patients (racial/ethnic minorities n = 301, 67% vs. whites: n = 4677, 73%; p = 0.024). On multivariable analysis, after controlling for clinical factors, racial/ethnic minority patients remained 22% less likely than whites to initiate hospice services prior to death (OR 0.78, 95% CI 0.63-0.96). Despite overall lower use of hospice, racial/ethnic minority patients had comparable odds of late hospice utilization (i.e., within 3 days of death) versus white patients (OR 1.5, 95% CI 0.73-1.50).
While most patients undergoing pancreatectomy for pancreatic cancer utilized hospice services prior to death, racial/ethnic minorities were less likely to use hospice services than whites.
我们旨在确定胰腺癌胰腺切除术后少数族裔患者的临终关怀利用的发生率并描述其时间模式。
使用 2013 年至 2017 年的 Medicare 标准分析文件，确定接受胰腺切除术治疗胰腺癌的患者。使用逻辑回归确定种族与死亡患者临终关怀利用模式之间的关联。
在 14495 名接受胰腺切除术治疗胰腺癌的患者中（中位年龄 73 岁；52.3%为女性；6.8%为少数族裔），有 47%（n=6859）在随访期末死亡。在死亡患者中，四分之三的患者（n=4978，72.6%）在死亡前使用了临终关怀服务。然而，与白人患者相比，少数族裔患者使用临终关怀服务的可能性较小（少数族裔患者 n=301，67%比白人患者 n=4677，73%；p=0.024）。在多变量分析中，在控制了临床因素后，少数族裔患者在死亡前开始临终关怀服务的可能性仍比白人患者低 22%（OR 0.78，95%CI 0.63-0.96）。尽管总体上临终关怀的使用较低，但少数族裔患者与白人患者相比，晚期临终关怀利用（即死亡前 3 天内）的可能性相当（OR 1.5，95%CI 0.73-1.50）。
虽然大多数接受胰腺切除术治疗胰腺癌的患者在死亡前使用了临终关怀服务，但少数族裔患者使用临终关怀服务的可能性低于白人患者。
