Nieder Carsten, Aanes Siv Gyda, Haukland Ellinor Christin
Department of Oncology and Palliative Medicine, Nordland Hospital, Bodø, Norway.
Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.
Contemp Oncol (Pozn). 2023;27(1):41-46. doi: 10.5114/wo.2023.127192. Epub 2023 Apr 27.
To calculate the number of days patients with terminal non-small cell lung cancer (NSCLC) spent at home in the last 3 months of life, and to identify factors that predict a lower proportion of days at home.
Retrospective study of 434 deceased patients with NSCLC. The number of days spent in a hospital or nursing home was identified from electronic health records.
Most patients received primary chemotherapy. Only 45% received palliative care provided by a dedicated palliative care team (PCT). In the last 3 months of life, only 39 patients (9%) were not hospitalized. The median number of days spent in hospital was 17, range 0-61. Hospital death occurred in 48%. Admission to a nursing home was recorded in 45%. Overall, the patients spent a median of 64 days at home. Both, older patients and females spent fewer days at home. Family network and aspects of palliative care, possibly reflecting the symptom duration or burden, also impacted days at home.
Long-lasting need for PCT support (not just the final 3 months) and earlier necessity for opioid analgesics were predictive for a reduced number of days at home. However, modifiable factors such as sex were identified too.
计算晚期非小细胞肺癌（NSCLC）患者生命最后3个月在家度过的天数，并确定预测在家天数比例较低的因素。
对434例已故NSCLC患者进行回顾性研究。从电子健康记录中确定在医院或疗养院度过的天数。
大多数患者接受了一线化疗。只有45%的患者接受了由专门的姑息治疗团队（PCT）提供的姑息治疗。在生命的最后3个月，只有39名患者（9%）未住院。住院天数的中位数为17天，范围为0至61天。48%的患者在医院死亡。45%的患者记录入住了疗养院。总体而言，患者在家度过的天数中位数为64天。老年患者和女性在家度过的天数较少。家庭网络和姑息治疗的各个方面，可能反映了症状持续时间或负担，也影响了在家的天数。
对PCT支持的长期需求（不仅仅是最后3个月）和更早使用阿片类镇痛药的必要性预示着在家天数减少。然而，也确定了一些可改变的因素，如性别。
