Einstein Medical Center, Philadelphia, USA.
University of Texas School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA.
J Palliat Care. 2023 Apr;38(2):167-174. doi: 10.1177/08258597211073226. Epub 2022 Jan 10.
Research has shown that palliative care improves the quality of life of cancer patients; however, there is no literature on specific factors that predict its use in diffuse large b-cell lymphoma (DLBCL) patients. Therefore, the prevalence of palliative care utilization and predictors of palliative care utilization among patients with DLBCL were examined. Data from the National Inpatient Sample (NIS) collected between 2016 to 2018 were used for all analyses. Multivariable logistic regression models were used to examine the predictors of palliative care utilization among hospitalized patients with DLBCL. Descriptive analyses were used to explore the overall prevalence of palliative care receipt in this population. Of the 41,789 hospitalizations, 7.1% of patients used palliative care during hospitalization, while 4.8% utilized palliative care and were discharged alive. DLBCL patients aged 70 and older had 1.3 times (95% CI: 1.14-1.41) higher odds of utilizing palliative care compared to those less than 70 years. Relative to Medicare/Medicaid patients, those with other types of insurance were 1.7 times (95% CI: 1.34-2.05) more likely to receive palliative care. Those who were either transferred to a facility/discharged with home health (AOR: 6.23; 95% CI: 5.21-7.44) or died during hospitalization (AOR: 45.17; 95% CI: 36.98-55.17) had higher odds of receiving palliative care when relative to those with a routine hospital discharge. Other associated factors were type of admission, length of stay, chemotherapy receipt, and number of comorbidities. The prevalence of palliative care utilization was low and factors predicting utilization in our population were identified. Our findings highlight the need to increase awareness among medical oncologists on the need to involve the palliative care team early in the management of hospitalized patients with DLBCL.
研究表明，姑息治疗可提高癌症患者的生活质量；然而，目前尚无关于预测弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者使用姑息治疗的具体因素的文献。因此，本研究旨在调查 DLBCL 患者姑息治疗的使用情况和预测因素。所有分析均使用 2016 年至 2018 年期间国家住院患者样本 (NIS) 中的数据。多变量逻辑回归模型用于检查住院 DLBCL 患者姑息治疗使用的预测因素。描述性分析用于探索该人群中接受姑息治疗的总体比例。在 41789 例住院患者中，7.1%的患者在住院期间使用姑息治疗，4.8%的患者接受姑息治疗并活着出院。70 岁及以上的 DLBCL 患者与小于 70 岁的患者相比，使用姑息治疗的可能性高 1.3 倍（95%CI：1.14-1.41）。与医疗保险/医疗补助患者相比，其他类型保险的患者接受姑息治疗的可能性高 1.7 倍（95%CI：1.34-2.05）。与常规出院相比，转至医疗机构/出院时接受家庭健康护理（AOR：6.23；95%CI：5.21-7.44）或住院期间死亡（AOR：45.17；95%CI：36.98-55.17）的患者接受姑息治疗的可能性更高。其他相关因素包括入院类型、住院时间、化疗接受情况和合并症数量。姑息治疗的使用率较低，确定了预测本人群使用的因素。我们的研究结果强调，需要提高肿瘤内科医生对在管理住院 DLBCL 患者时尽早让姑息治疗团队参与的必要性。
