Pattern and characteristics of advanced cancer patients admitted to hospices in Italy.

The aim of this multicenter study was to assess the pattern and the characteristics of advanced cancer patients admitted to hospices. A consecutive sample of patients admitted in a period of 6 months was taken into consideration. Two hundred thirty-six patients admitted to hospices were consecutivel...

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Published in:Supportive Care in Cancer Vol. 21; no. 4; pp. 935 - 940
Main Authors: Mercadante, Sebastiano, Valle, Alessandro, Sabba, Silvana, Orlando, Antonio, Guolo, Francesca, Gulmini, Loretta, Ori, Sara, Bellingardo, Rosanna, Casuccio, Alessandra
Format: research Journal Article
Published: Springer Nature Apr2013
Online Access:View this record in EBSCOhost
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      dt: Apr2013
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      pub: Springer Nature
      place: New York, New York
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        atl: Pattern and characteristics of advanced cancer patients admitted to hospices in Italy.
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          Mercadante, Sebastiano
          Valle, Alessandro
          Sabba, Silvana
          Orlando, Antonio
          Guolo, Francesca
          Gulmini, Loretta
          Ori, Sara
          Bellingardo, Rosanna
          Casuccio, Alessandra
        affil: Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Palermo, Italy, terapiadeldolore@lamaddalenanet.it.
      sug:
        subj:
          Hospices
          Neoplasms Mortality
          Neoplasms Pathology
          Palliative Care
          Adult
          Aged
          Aged, 80 and Over
          Analgesics, Opioid Administration and Dosage
          Female
          Human
          Italy
          Length of Stay
          Logistic Regression
          Male
          Marital Status
          Middle Age
          Outcome Assessment Statistics and Numerical Data
          Prospective Studies
          Survival Analysis
          Terminal Care
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: The aim of this multicenter study was to assess the pattern and the characteristics of advanced cancer patients admitted to hospices. A consecutive sample of patients admitted in a period of 6 months was taken into consideration. Two hundred thirty-six patients admitted to hospices were consecutively assessed. Ninety-six percent of patients were admitted in acute hospital in the previous 3 months, with a mean time spent in hospital of 34.5 days, and 47 % of patients had received chemotherapy the month before hospice admission. Thirty-four percent of patients for whom data were available had significant persistent pain, and 44 % of them presented episodes of breakthrough pain. Sixty-one percent of patients were receiving opioid drugs at admission, and 70 % the day before death, with parenteral morphine and transdermal fentanyl being the opioids most frequently administered. The mean admission time in hospice was 18.4 days. Eighty-six percent died in hospice. Palliative sedation was performed in 25 % of patients who died in hospice. The short survival and the number of patients dying in hospice were the principal finding, as it appears that hospice admission is only one way for end of life treatments. Patients receive specialized palliative care only for 2-3 weeks before death, implying an inacceptable timing for patients with several problems presumed to be present early during the course of disease. Data from hospice activities in Italy strongly suggest to spread palliative care in other settings, other than home care and hospice, to intercept oncologic patients in their disease trajectory early.
      pubtype: Academic Journal
      doctype:
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        Journal Article
      ougenre: Article
    language: English
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