单一学术中心住院原发性和继发性脑肿瘤患者的姑息治疗咨询。
Palliative Care Consultation for Hospitalized Patients with Primary and Secondary Brain Tumors at a Single Academic Center.
机构信息
Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Dartmouth Hitchcock and Geisel School of Medicine, Lebanon, New Hampshire, USA.
出版信息
J Palliat Med. 2021 Sep;24(10):1550-1554. doi: 10.1089/jpm.2021.0088. Epub 2021 Jun 24.
Studies addressing palliative care delivery in neuro-oncology are limited. To compare inpatients with brain tumors who received palliative care (through referral or trigger) with those receiving usual care. Retrospective cohort study. Inpatients with primary or secondary brain tumors who did or did not receive palliative care at a U.S. medical center. Sociodemographic, clinical, and utilization characteristics were compared. Of 1669 brain tumor patients, 386 (23.1%) received palliative care [nontrigger: 246 (14.7%); trigger: 140 (8.4%)] and 1283 (76.9%) received usual care. Nontrigger patients were oldest (mean age 65.0 years; trigger: 61.1 years; usual care: 55.5 years; < 0.001); sickest at baseline (mean Elixhauser comorbidity index 3.76; trigger: 3.49; usual care: 1.84; < 0.001); and had highest in-hospital death [34 (13.8%), trigger: 10 (7.1%), usual care: 7 (0.5%); < 0.001] and hospice discharge [54 (22.0%), trigger: 18 (12.9%), usual care: 14 (1.1%); < 0.001]. Trigger criteria may promote earlier palliative care referral, yet criteria tailored for neuro-oncology are undeveloped.
神经肿瘤学中姑息治疗的研究有限。本研究旨在比较接受姑息治疗（通过转介或触发）和接受常规治疗的脑肿瘤住院患者。这是一项回顾性队列研究。研究对象为在美国医疗中心接受治疗的原发性或继发性脑肿瘤住院患者，比较了接受和未接受姑息治疗患者的人口统计学、临床和利用特征。在 1669 名脑肿瘤患者中，386 名（23.1%）接受了姑息治疗[非触发：246 名（14.7%）；触发：140 名（8.4%）]，1283 名（76.9%）接受了常规治疗。非触发患者年龄最大（平均年龄 65.0 岁；触发：61.1 岁；常规治疗：55.5 岁；<0.001）；基线时病情最严重（平均 Elixhauser 合并症指数 3.76；触发：3.49；常规治疗：1.84；<0.001）；院内死亡率最高[34 名（13.8%），触发：10 名（7.1%），常规治疗：7 名（0.5%）；<0.001]和临终关怀出院率最高[54 名（22.0%），触发：18 名（12.9%），常规治疗：14 名（1.1%）；<0.001]。触发标准可能会促进更早的姑息治疗转介，但针对神经肿瘤学的标准尚未开发。
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