胃肠道癌症患者的积极临终关怀--一项来自丹麦的全国性研究。

IF 2.7 3区 医学 Q3 ONCOLOGY Acta Oncologica Pub Date : 2024-11-24 DOI:10.2340/1651-226X.2024.41008
Stine Gerhardt, Kirstine Skov Benthien, Suzanne Herling, Marie Villumsen, Peter-Martin Karup
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引用次数: 0

摘要

背景:了解积极临终关怀的决定因素对于为胃肠道癌症(GI)患者组织有效的姑息治疗至关重要。目的:本研究旨在调查胃肠道癌症患者积极临终关怀的决定因素:研究方法:使用丹麦死亡原因登记册、丹麦国家患者登记册和丹麦姑息治疗数据库中的数据,开展一项基于国家登记册的队列研究:研究对象/背景:2010年至2020年期间死于消化道癌症的所有丹麦患者:队列中有43969名消化道癌症患者,其中62%的患者在生命的最后30天住院治疗,41%的患者在医院死亡,10%的患者接受了手术,39%的患者在生命的最后30天接受了放射检查,3%的患者在生命的最后14天接受了抗肿瘤治疗。在所有类型的消化道癌症中,胰腺癌与除手术外的所有积极临终关怀结果都有显著相关性。接受专科姑息治疗(SPC)的患者接受积极临终关怀和在医院死亡的几率较低。我们发现,合并症患者和离婚患者在生命末期住院和在医院死亡的几率更高:积极的临终关怀与疾病因素和社会人口统计学有关。在消化道癌症患者中,减少积极的临终关怀的潜力相当大,SPC 的影响就证明了这一点。然而,我们需要解决未接受 SPC 的消化道癌症患者的需求。
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Aggressive end-of-life care in patients with gastrointestinal cancers - a nationwide study from Denmark.

Background: Knowledge of determinants of aggressive end-of-life care is crucial to organizing effective palliative care for patients with gastrointestinal (GI) cancer.

Purpose: This study aims to investigate the determinants of aggressive end-of-life care in patients with GI cancer.

Methods: A national register-based cohort study using data from the Danish Register on Causes of Death, the Danish National Patient Register, and the Danish Palliative Database was the method of study employed.

Participants/setting: All Danish patients who died from GI cancers from 2010 to 2020 comprised the study setting.

Results: There were 43,969 patients with GI cancers in the cohort, of whom 62% were hospitalized in the last 30 days of life, 41% of patients died in the hospital, 10% had surgery, 39% were subjected to a radiological examination during the last 30 days of life and 3% had antineoplastic treatment during the last 14 days of life. Among all types of GI cancers, pancreatic cancer was significantly associated with all outcomes of aggressive end-of-life care except surgery. Patients in specialized palliative care (SPC) had lower odds of receiving aggressive end-of-life care and dying in the hospital. We found that patients with comorbidity and those who were divorced had higher odds of being hospitalized at the end of life and dying in the hospital.

Interpretation: Aggressive end-of-life care is associated with disease factors and socio-demographics. The potential to reduce aggressive end-of-life care is considerable in patients with GI cancer, as demonstrated by the impact of SPC. However, we need to address the needs of patients with GI cancer who do not receive SPC.

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来源期刊
Acta Oncologica
Acta Oncologica 医学-肿瘤学
CiteScore
4.30
自引率
3.20%
发文量
301
审稿时长
3 months
期刊介绍: Acta Oncologica is a journal for the clinical oncologist and accepts articles within all fields of clinical cancer research. Articles on tumour pathology, experimental oncology, radiobiology, cancer epidemiology and medical radio physics are also welcome, especially if they have a clinical aim or interest. Scientific articles on cancer nursing and psychological or social aspects of cancer are also welcomed. Extensive material may be published as Supplements, for which special conditions apply.
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