Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-19T14:07:13.613Z Has data issue: false hasContentIssue false
  • English
  • Français

Does gynecologic malignancy predict likelihood of a tertiary palliative care unit hospital admission? A comparison of local, provincial and national death rates

Published online by Cambridge University Press:  22 May 2012

Jana Pilkey ,
Chantale Demers ,
Harvey Chochinov  and
Nithya Venkatesan
Jana Pilkey*
Affiliation:
Department of Family Medicine, Section of Palliative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
Chantale Demers
Affiliation:
Department of Family Medicine, Section of Palliative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
Harvey Chochinov
Affiliation:
Department of Family Medicine, Section of Palliative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Department of Psychiatry, Section of Palliative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada Manitoba Palliative Care Research Unit, Winnipeg, Manitoba, Canada
Nithya Venkatesan
Affiliation:
Department of Internal Medicine, University of Manitoba, Victoria General Hospital Winnipeg, Manitoba, Canada
*
Address correspondence and reprint requests to: Jana Pilkey, Winnipeg Regional Health Authority, A8024 St.Boniface General Hospital, 409 Tache Ave. Winnipeg, MB, Canada R2H 2A6. E-mail: jpilkey@wrha.mb.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The purpose of this study was to determine whether the presence of gynecologic malignancies predicts the likelihood of a tertiary palliative care unit hospital admission.

Method:

In this study, patients admitted to a specialized tertiary palliative care unit (TPCU) with gynecologic malignancies were compared to national and provincial death rates to determine if gynecologic malignancy predicts admission, and subsequent death, in a TPCU.

Results:

Eighty-two gynecologic cancer patients were admitted to our TPCU over the 5- year study period. Out of all cancer deaths in the TPCU, death from ovarian cancer was 3.7% compared with 2.4% (p = 0.0068) of all cancer deaths in Manitoba and 2.3% (p = 0.0043) of all cancer deaths in Canada. Cervical cancer accounted for 1.7% of all our patients deaths compared with 0.7% (p = 0.0001) provincially and 0.6% (p = 0.0001) nationally. Uterine cancer deaths were not significantly different from the provincial and national death rates, whereas vulvar and fallopian cancers were too rare to allow for statistical analysis.

Significance of Results:

Gynecologic cancers may be predictive of admission to a palliative care unit.

Keywords

Palliative careGynecologic malignanciesAdmissionDeath rates
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 249 - 254
Copyright
Copyright © Cambridge University Press 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Brookfield, K.F., Cheung, M.C., Lucci, J., et al. (2009). Disparities in survival among women with invasive cervical cancer: A problem of access to care. Cancer, 115, 166–178.CrossRefGoogle ScholarPubMed
Bruera, E., Sweeney, C., Russell, N., et al. (2003). Place of death of Houston area residents with cancer over a two-year period. Journal of Pain and Symptom Management, 26, 637–643.Google Scholar
Constantini, M., Camoirano, E., Madeddu, L., et al. (1993). Palliative home care and place of death among cancer patients: a population-based study. Palliative Medicine, 7, 323–331.Google Scholar
Dalrymple, J.L., Levenback, C., Wolf, J., et al. (2002). Trends among gynecologic oncology inpatient deaths: Is end-of-life care improving? Gynecologic Oncology, 85, 356–361.Google Scholar
De Conno, F., Caraceni, A., Groff, L., et al. (1996). Effect of home care on the place of death of advanced cancer patients. European Journal of Cancer, 32A, 1142–1147.Google Scholar
Dunlop, R., Davies, R.J. & Hockley, J. (1989). Preferred vs. actual place of death: A hospital palliative care support team experience. Palliative Medicine, 3, 197–201.Google Scholar
Fukui, S., Kawagoe, H., Masako, S., et al. (2003). Determinants of the place of death among terminally ill cancer patients under home hospice care in Japan. Palliative Medicine, 17, 445–453.Google Scholar
Gomes, B. & Higginson, J. (2006). Factors influencing death at home in terminally ill patients with cancer: systematic review. British Medical Journal, 332, 515–521.Google Scholar
Higginson, I.J., Astin, P. & Dolan, S. (1998). Where do cancer patients die? Ten-year trends in the place of death of cancer patients in England. Palliative Medicine, 12, 353–363.Google Scholar
Higginson, I.J., Jarman, B., Astin, P., et al. (1999). Do social factors affect where patients die: an analysis of 10 years of cancer deaths in England. Journal of Public Health Medicine, 21, 22–28.Google Scholar
Hunt, R., Bonett, A. & Roder, D. (1993). Trends in the terminal care of cancer patients: South Australia, 1981–1990. Australian and New Zealand Journal of Medicine, 23, 245–251.Google Scholar
Izquierdo_Porrera, A., Trelis-Navarro, J. & Gomez-Batiste, X. (2001). Predicting place of death of elderly cancer patients followed by a palliative care unit. Journal of Pain and Symptom Management, 21, 481–490.Google Scholar
Karlsen, S. & Addington-Hall, J. (1998). How do cancer patients who die at home differ from those who die elsewhere? Palliative Medicine, 12, 279–286.Google Scholar
Mann, W.J., Loesch, M., Shurpin, K.M. & Chalas, E. (1993). Determinants of home versus hospital terminal care for patients with gynecologic cancer. Cancer, 9, 2876–2879.Google Scholar
McCusker, J. (1983). Where cancer patients die: an epidemiologic study. Public Health Report, 98, 170–176.Google Scholar
Movva, S., Noone, A.M., Banerjee, M., et al. (2008). Racial differences in cervical cancer survival in the Detroit metropolitan area. Cancer, 112, 1264–71.CrossRefGoogle ScholarPubMed
Pilkey, J. & Daeninck, P. (2008). A retrospective analysis of the use of dexamethasone on a canadian palliative care unit. Progress in Palliative Care, 6, 63–68.CrossRefGoogle Scholar
Townsend, J., Frank, A.O., Fermont, D., et al. (1990). Terminal cancer and patients' preference for place of death: a prospective study. British Medical Journal, 301, 415–417.Google Scholar
Trunca, J.C., Buchler, D.A., Mack, E.A., et al. (1981). The management of ovarian-cancer-caused bowel obstruction. Gynecologic Oncology, 12, 186–192.CrossRefGoogle Scholar