Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care
Abstract Background Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investi...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Palliative Care |
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| Online Access: | http://link.springer.com/article/10.1186/s12904-020-00579-0 |
| _version_ | 1818308087634722816 |
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| author | Ellinor Christin Haukland Christian von Plessen Carsten Nieder Barthold Vonen |
| author_facet | Ellinor Christin Haukland Christian von Plessen Carsten Nieder Barthold Vonen |
| author_sort | Ellinor Christin Haukland |
| collection | DOAJ |
| description | Abstract Background Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer care. Methods Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway in 2012 and 2013. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life. Results 30% of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62% more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1000 patient days (p < 0.001, OR 1.62 (1.23–2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18% (p = 0.045, OR 1.85 (1.01–3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1000 patient days in both groups by 29% (p = 0.02, IRR 0.71, CI 95% 0.53–0.96). Conclusions Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective. |
| first_indexed | 2024-12-13T07:08:42Z |
| format | Article |
| id | doaj.art-232e0df55aa0480db01c060dd3156349 |
| institution | Directory Open Access Journal |
| issn | 1472-684X |
| language | English |
| last_indexed | 2024-12-13T07:08:42Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Palliative Care |
| spelling | doaj.art-232e0df55aa0480db01c060dd31563492022-12-21T23:55:42ZengBMCBMC Palliative Care1472-684X2020-06-011911910.1186/s12904-020-00579-0Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer careEllinor Christin Haukland0Christian von Plessen1Carsten Nieder2Barthold Vonen3Department of Oncology and Palliative Medicine, Nordland Hospital TrustDirection Générale de la SantéDepartment of Oncology and Palliative Medicine, Nordland Hospital TrustInstitute of Community Medicine, The Arctic University of NorwayAbstract Background Anticancer treatment exposes patients to negative consequences such as increased toxicity and decreased quality of life, and there are clear guidelines recommending limiting use of aggressive anticancer treatments for patients near end of life. The aim of this study is to investigate the association between anticancer treatment given during the last 30 days of life and adverse events contributing to death and elucidate how adverse events can be used as a measure of quality and safety in end-of-life cancer care. Methods Retrospective cohort study of 247 deceased hospitalised cancer patients at three hospitals in Norway in 2012 and 2013. The Global Trigger Tool method were used to identify adverse events. We used Poisson regression and binary logistic regression to compare adverse events and association with use of anticancer treatment given during the last 30 days of life. Results 30% of deceased hospitalised cancer patients received some kind of anticancer treatment during the last 30 days of life, mainly systemic anticancer treatment. These patients had 62% more adverse events compared to patients not being treated last 30 days, 39 vs. 24 adverse events per 1000 patient days (p < 0.001, OR 1.62 (1.23–2.15). They also had twice the odds of an adverse event contributing to death compared to patients without such treatment, 33 vs. 18% (p = 0.045, OR 1.85 (1.01–3.36)). Receiving follow up by specialist palliative care reduced the rate of AEs per 1000 patient days in both groups by 29% (p = 0.02, IRR 0.71, CI 95% 0.53–0.96). Conclusions Anticancer treatment given during the last 30 days of life is associated with a significantly increased rate of adverse events and related mortality. Patients receiving specialist palliative care had significantly fewer adverse events, supporting recommendations of early integration of palliative care in a patient safety perspective.http://link.springer.com/article/10.1186/s12904-020-00579-0Adverse eventEnd of lifePalliative careGlobal trigger toolPatient safety |
| spellingShingle | Ellinor Christin Haukland Christian von Plessen Carsten Nieder Barthold Vonen Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care BMC Palliative Care Adverse event End of life Palliative care Global trigger tool Patient safety |
| title | Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care |
| title_full | Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care |
| title_fullStr | Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care |
| title_full_unstemmed | Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care |
| title_short | Adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end-of-life cancer care |
| title_sort | adverse events in deceased hospitalised cancer patients as a measure of quality and safety in end of life cancer care |
| topic | Adverse event End of life Palliative care Global trigger tool Patient safety |
| url | http://link.springer.com/article/10.1186/s12904-020-00579-0 |
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