Associations between health-related quality of life and subsequent need for specialized palliative care and hospital utilization in patients with gastrointestinal cancer-a prospective single-center cohort study

Stine Gerhardt*, Kirstine Skov Benthien, Suzanne Herling, Bonna Leerhøy, Lene Jarlbaek, Peter-Martin Krarup

*Corresponding author for this work

Abstract

BACKGROUND: We lack knowledge of which factors are associated with the risk of developing complex palliative care needs. The aim of this study was to investigate the associations between patient-reported health-related quality of life and subsequent referral to specialized palliative care (SPC) and hospital utilization.

METHODS: This was a prospective single-center cohort study. Data on patient-reported outcomes were collected through the European Organization of Research and Treatment of Cancer Questionnaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the time of diagnosis. Covariates and hospital utilization outcomes were collected from medical records. Adjusted logistic and Poisson regression were applied in the analyses. Participants were newly diagnosed with incurable gastrointestinal cancer and affiliated with a palliative care case management intervention established in a gastroenterology department.

RESULTS: Out of 397 patients with incurable gastrointestinal cancer, 170 were included in the study. Patients newly diagnosed with incurable gastrointestinal cancer experienced a substantial burden of symptoms. Pain was significantly associated with subsequent referral to SPC (OR 1.015; 95% CI 1.001-1.029). Patients with lower education levels (OR 0.210; 95% CI 0.056-0.778) and a Charlson Comorbidity Index score of 2 or more (OR 0.173; 95% CI 0.041-0.733) were less likely to be referred to SPC. Pain (IRR 1.011; 95% CI 1.005-1.018), constipation (IRR 1.009; 95% CI 1.004-1.015), and impaired overall quality of life (IRR 0.991; 95% CI 0.983-0.999) were significantly associated with increased risk of hospital admissions.

CONCLUSION: The study indicates a need for interventions in hospital departments to identify and manage the substantial symptom burden experienced by patients, provide palliative care, and ensure timely referral to SPC.

Original languageEnglish
Article number311
JournalSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
Volume32
Issue number5
Pages (from-to)311
ISSN0941-4355
DOIs
Publication statusPublished - 27 Apr 2024

Keywords

  • Humans
  • Palliative Care/methods
  • Quality of Life
  • Male
  • Prospective Studies
  • Female
  • Gastrointestinal Neoplasms/therapy
  • Aged
  • Middle Aged
  • Hospitalization/statistics & numerical data
  • Cohort Studies
  • Surveys and Questionnaires
  • Aged, 80 and over
  • Referral and Consultation/statistics & numerical data
  • Patient Reported Outcome Measures
  • Adult

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