Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes
Malignant pleural mesothelioma is a rare, aggressive, and incurable cancer with a poor prognosis and high symptom burden. For these patients, little is known about the impact of palliative care consultation on outcomes such as mortality, hospital admissions, or emergency department visits. The aim o...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/31/2/76 |
| _version_ | 1827343828096385024 |
|---|---|
| author | Andrew Baird Abdullah Nasser Peter Tanuseputro Colleen Webber Paul Wheatley-Price Camille Munro |
| author_facet | Andrew Baird Abdullah Nasser Peter Tanuseputro Colleen Webber Paul Wheatley-Price Camille Munro |
| author_sort | Andrew Baird |
| collection | DOAJ |
| description | Malignant pleural mesothelioma is a rare, aggressive, and incurable cancer with a poor prognosis and high symptom burden. For these patients, little is known about the impact of palliative care consultation on outcomes such as mortality, hospital admissions, or emergency department visits. The aim of this study is to determine if referral to supportive and palliative care in patients with malignant pleural mesothelioma is associated with survival and decreased hospital admissions and emergency department visits. This is a retrospective chart review. Study participants include all malignant pleural mesothelioma patients seen at The Ottawa Hospital—an acute care tertiary center—between January 2002 and March 2019. In total, 223 patients were included in the study. The mean age at diagnosis was 72.4 years and 82.5% were male. Of the patients diagnosed between 2002 and 2010, only 11 (9.6%) were referred to palliative care. By comparison, of those diagnosed between 2011 and 2019, 49 (45.4%) were referred to palliative care. Median time from diagnosis to referral was 4.1 months. There was no significant difference in the median survival of patients referred for palliative care compared to those who did not receive palliative care (<i>p</i> = 0.46). We found no association between receiving palliative care and the mean number of hospital admissions (1.04 vs. 0.91) from diagnosis to death, and an increase in mean number of emergency department visits in the palliative care group (2.30 vs. 1.18). Although there was increased utilization of palliative care services, more than half of the MPM patients did not receive palliative care despite their limited survival. There was an increase in emergency department visits in the palliative care group; this may represent an increase in the symptom burden (i.e., indication bias) in those referred to palliative care. |
| first_indexed | 2024-03-07T22:36:57Z |
| format | Article |
| id | doaj.art-d3a08fb0ebe94afc82ab281437b5c61e |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-07T22:36:57Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-d3a08fb0ebe94afc82ab281437b5c61e2024-02-23T15:13:27ZengMDPI AGCurrent Oncology1198-00521718-77292024-02-013121028103410.3390/curroncol31020076Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life OutcomesAndrew Baird0Abdullah Nasser1Peter Tanuseputro2Colleen Webber3Paul Wheatley-Price4Camille Munro5Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, CanadaDepartment of Oncology, Western University, London, ON N8W 2X3, CanadaDepartment of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, CanadaBruyère Research Institute, Ottawa, ON K1R 6M1, CanadaDepartment of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, CanadaDepartment of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, CanadaMalignant pleural mesothelioma is a rare, aggressive, and incurable cancer with a poor prognosis and high symptom burden. For these patients, little is known about the impact of palliative care consultation on outcomes such as mortality, hospital admissions, or emergency department visits. The aim of this study is to determine if referral to supportive and palliative care in patients with malignant pleural mesothelioma is associated with survival and decreased hospital admissions and emergency department visits. This is a retrospective chart review. Study participants include all malignant pleural mesothelioma patients seen at The Ottawa Hospital—an acute care tertiary center—between January 2002 and March 2019. In total, 223 patients were included in the study. The mean age at diagnosis was 72.4 years and 82.5% were male. Of the patients diagnosed between 2002 and 2010, only 11 (9.6%) were referred to palliative care. By comparison, of those diagnosed between 2011 and 2019, 49 (45.4%) were referred to palliative care. Median time from diagnosis to referral was 4.1 months. There was no significant difference in the median survival of patients referred for palliative care compared to those who did not receive palliative care (<i>p</i> = 0.46). We found no association between receiving palliative care and the mean number of hospital admissions (1.04 vs. 0.91) from diagnosis to death, and an increase in mean number of emergency department visits in the palliative care group (2.30 vs. 1.18). Although there was increased utilization of palliative care services, more than half of the MPM patients did not receive palliative care despite their limited survival. There was an increase in emergency department visits in the palliative care group; this may represent an increase in the symptom burden (i.e., indication bias) in those referred to palliative care.https://www.mdpi.com/1718-7729/31/2/76palliative caremesotheliomasurvivalemergency departmentspatient admission |
| spellingShingle | Andrew Baird Abdullah Nasser Peter Tanuseputro Colleen Webber Paul Wheatley-Price Camille Munro Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes Current Oncology palliative care mesothelioma survival emergency departments patient admission |
| title | Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes |
| title_full | Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes |
| title_fullStr | Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes |
| title_full_unstemmed | Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes |
| title_short | Involvement of Palliative Care in Malignant Pleural Mesothelioma Patients and Associations with Survival and End-of-Life Outcomes |
| title_sort | involvement of palliative care in malignant pleural mesothelioma patients and associations with survival and end of life outcomes |
| topic | palliative care mesothelioma survival emergency departments patient admission |
| url | https://www.mdpi.com/1718-7729/31/2/76 |
| work_keys_str_mv | AT andrewbaird involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes AT abdullahnasser involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes AT petertanuseputro involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes AT colleenwebber involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes AT paulwheatleyprice involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes AT camillemunro involvementofpalliativecareinmalignantpleuralmesotheliomapatientsandassociationswithsurvivalandendoflifeoutcomes |