Keiran K Tuck1, Dana M Zive2, Terri A Schmidt3, Julie Carter1, John Nutt1, Erik K Fromme4. 1. Department of Neurology, Oregon Health & Science University, Mail Code OP32, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. 2. Department of Emergency Medicine, Oregon Health & Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. 3. Department of Emergency Medicine, Oregon Health & Science University 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA; Palliative Care Service, Mail Code L586, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. 4. Palliative Care Service, Mail Code L586, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA. Electronic address: frommee@ohsu.edu.
Abstract
INTRODUCTION: End-of-life care in Parkinson's Disease (PD) is poorly described. Physician Orders for Life Sustaining Treatment (POLST) forms specify how much life-sustaining treatment to provide. This study aims to better understand end-of-life care in PD using data from the Oregon POLST and Death Registries. METHODS: Oregon death certificates from the years 2010-2011 were analyzed. Death certificates were matched with forms in the Oregon POLST Registry. Descriptive analyses were performed for both the full PD dataset as well as those with POLST forms. RESULTS: There were 1073 (1.8%) decedents with PD listed as a cause of death and 56,961 without. Three hundred and seventy three (35%) decedents with PD had a POLST form. POLST preferences were not significantly different between those with or without PD, however location of death was; hospital (13% PD vs 24% without p < 0.01), home (32% vs 40% p < 0.01) and care facility (52% vs 29% p < 0.01). Compared to those without a POLST or those without a Comfort Measures Only (CMO) order, decedents with PD and a CMO order were less likely to die in a hospital (5.4% vs 14.7% p < 0.01) and more likely to die at home (39.1% vs 29.1% p < 0.01). In those with PD, dementia was the most common comorbid condition listed on death certificates (16%). CONCLUSION: Decedents with PD die less frequently at home than the general population. POLST forms mitigate some of this discrepancy. While not often thought to be terminal, PD and its complications are commonly recorded causes of death.
INTRODUCTION: End-of-life care in Parkinson's Disease (PD) is poorly described. Physician Orders for Life Sustaining Treatment (POLST) forms specify how much life-sustaining treatment to provide. This study aims to better understand end-of-life care in PD using data from the Oregon POLST and Death Registries. METHODS: Oregon death certificates from the years 2010-2011 were analyzed. Death certificates were matched with forms in the Oregon POLST Registry. Descriptive analyses were performed for both the full PD dataset as well as those with POLST forms. RESULTS: There were 1073 (1.8%) decedents with PD listed as a cause of death and 56,961 without. Three hundred and seventy three (35%) decedents with PD had a POLST form. POLST preferences were not significantly different between those with or without PD, however location of death was; hospital (13% PD vs 24% without p < 0.01), home (32% vs 40% p < 0.01) and care facility (52% vs 29% p < 0.01). Compared to those without a POLST or those without a Comfort Measures Only (CMO) order, decedents with PD and a CMO order were less likely to die in a hospital (5.4% vs 14.7% p < 0.01) and more likely to die at home (39.1% vs 29.1% p < 0.01). In those with PD, dementia was the most common comorbid condition listed on death certificates (16%). CONCLUSION: Decedents with PD die less frequently at home than the general population. POLST forms mitigate some of this discrepancy. While not often thought to be terminal, PD and its complications are commonly recorded causes of death.
Authors: Kelly C Vranas; Wesley Plinke; Donald Bourne; Devan Kansagara; Robert Y Lee; Erin K Kross; Christopher G Slatore; Donald R Sullivan Journal: J Am Geriatr Soc Date: 2021-09-22 Impact factor: 7.538
Authors: Martin Klietz; Amelie Tulke; Lars H Müschen; Lejla Paracka; Christoph Schrader; Dirk W Dressler; Florian Wegner Journal: Front Neurol Date: 2018-03-06 Impact factor: 4.003