Background and importance Despite advances in the early detection and treatment of cancer, a large proportion of patients still eventually die as a result of their disease. The quality of medical care delivered to cancer patients near the end of life is of significant concern.
Aim and objectives To evaluate therapeutic aggressiveness near the end of life in patients with pancreatic cancer and implantation of palliative care in hospital.
Material and methods A retrospective observational study was carried out from January 2017 to August 2019 in a tertiary hospital. We included patients with pancreatic cancer receiving antineoplastic intravenous treatment followed by the oncology service and who died as a result of their disease. Patients were followed from inclusion until 31 August 2019 or death. To define therapeutic aggressiveness near the end of life, we used the criteria of Earle et al. Demographics and clinical parameters were collected from the medical history: age, gender, diagnosis date, ECOG, treatment line, start date and date of last administration, date and place of death and quality variables at the end of life (emergency care, hospital admission in the last month of life, admission to the intensive care unit (ICU) in the last month of life and assistance by the palliative care unit).
Results A total of 38 patients were evaluated. Mean age was 66.6 (SD 10.5) years, 58.0% were men, 92% had metastases and 50% had ECOG ≥2.21% and had received three or more lines of treatment (1 line=45%; 2 lines=34%).
Therapeutic aggressiveness criteria
10.5% received antineoplastic treatment in the last 14 days of life (aggressiveness limit ≥10%).
8% started a new antineoplastic treatment in the last 30 days of life (limit ≥2%).
29% went to the emergency room on more than one occasion or were admitted to the ICU during the last month of life (limit ≥4%).
52.6% died in the hospital acute unit (limit ≥17%).
0% received palliative care (limit <55%).
Conclusion and relevance Our population showed a slight excess of antineoplastic use at the end of life, which implies a greater demand for health resources (Earle et al criteria). The percentage of patients who died in hospital remained high. The results showed the need for greater implementation of palliative care in hospital.
References and/or acknowledgements No conflict of interest.
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