Jun Hamano1, Takashi Yamaguchi2, Isseki Maeda3, Akihiko Suga4, Takayuki Hisanaga5, Tatsuhiko Ishihara6, Tomoyuki Iwashita7, Keisuke Kaneishi8, Shohei Kawagoe9, Toshiyuki Kuriyama10, Takashi Maeda11, Ichiro Mori12, Nobuhisa Nakajima13, Tomohiro Nishi14, Hiroki Sakurai15, Satofumi Shimoyama16, Takuya Shinjo17, Hiroto Shirayama18, Takeshi Yamada19, Tatsuya Morita20. 1. Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan. 2. Department of Palliative Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. 3. Department of Palliative Medicine, Graduate School of Medicine, Osaka University, Suita, Japan. 4. Department of Palliative Medicine, Shizuoka Saiseikai General Hospital, Suruga, Japan. 5. Tsukuba Medical Center Foundation, Tsukuba, Japan. 6. Palliative Care Department, Okayama Saiseikai General Hospital, Okayama City, Japan. 7. Matsue City Hospital, Matsue City, Japan. 8. Department of Palliative Care Unit, Japan Community Health Care Organization (JCHO) Tokyo Shinjuku Medical Center, Tokyo, Japan. 9. Aozora Clinic, Matsudo City, Japan. 10. Department of Palliative Medicine, Wakayama Medical University Hospital Oncology Center, Wakayama, Japan. 11. Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Tokyo, Japan. 12. Gratia Hospital Hospice, Mino, Japan. 13. Department of Palliative Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan. 14. Kawasaki Comprehensive Care Center, Kawasaki Municipal Ida Hospital, Kawasaki, Japan. 15. Palliative Care Team, Cancer Institute Hospital, Tokyo, Japan. 16. Department of Palliative Care, Aichi Cancer Center Hospital, Nagoya, Japan. 17. Shinjo Clinic, Kobe Shinjo Clinic, Kobe, Japan. 18. Iryouhoujinn Takumikai Osaka Kita Homecare Clinic, Osaka City, Japan. 19. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. 20. Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu-Shi, Japan.
Abstract
BACKGROUND: Although the place of death has a great influence on the quality of death and dying for cancer patients, whether the survival time differs according to the place of death is unclear. The primary aim of this study was to explore potential differences in the survival time of cancer patients dying at home or in a hospital. METHODS: This multicenter, prospective cohort study was conducted in Japan from September 2012 through April 2014 and involved 58 specialist palliative care services. RESULTS: Among the 2426 patients recruited, 2069 patients were analyzed for this study: 1582 receiving hospital-based palliative care and 487 receiving home-based palliative care. A total of 1607 patients actually died in a hospital, and 462 patients died at home. The survival of patients who died at home was significantly longer than the survival of patients who died in a hospital in the days' prognosis group (estimated median survival time, 13 days [95% confidence interval (CI), 10.3-15.7 days] vs 9 days [95% CI, 8.0-10.0 days]; P = .006) and in the weeks' prognosis group (36 days [95% CI, 29.9-42.1 days] vs 29 days [95% CI, 26.5-31.5 days]; P = .007) as defined by Prognosis in Palliative Care Study predictor model A. No significant difference was identified in the months' prognosis group. Cox proportional hazards analysis revealed that the place of death had a significant influence on the survival time in both unadjusted (hazard ratio [HR], 0.86; 95% CI, 0.78-0.96; P < .01) and adjusted models (HR, 0.87; 95% CI, 0.77-0.97; P = .01). CONCLUSIONS: In comparison with cancer patients who died in a hospital, cancer patients who died at home had similar or longer survival. Cancer 2016;122:1453-1460.
BACKGROUND: Although the place of death has a great influence on the quality of death and dying for cancerpatients, whether the survival time differs according to the place of death is unclear. The primary aim of this study was to explore potential differences in the survival time of cancerpatients dying at home or in a hospital. METHODS: This multicenter, prospective cohort study was conducted in Japan from September 2012 through April 2014 and involved 58 specialist palliative care services. RESULTS: Among the 2426 patients recruited, 2069 patients were analyzed for this study: 1582 receiving hospital-based palliative care and 487 receiving home-based palliative care. A total of 1607 patients actually died in a hospital, and 462 patients died at home. The survival of patients who died at home was significantly longer than the survival of patients who died in a hospital in the days' prognosis group (estimated median survival time, 13 days [95% confidence interval (CI), 10.3-15.7 days] vs 9 days [95% CI, 8.0-10.0 days]; P = .006) and in the weeks' prognosis group (36 days [95% CI, 29.9-42.1 days] vs 29 days [95% CI, 26.5-31.5 days]; P = .007) as defined by Prognosis in Palliative Care Study predictor model A. No significant difference was identified in the months' prognosis group. Cox proportional hazards analysis revealed that the place of death had a significant influence on the survival time in both unadjusted (hazard ratio [HR], 0.86; 95% CI, 0.78-0.96; P < .01) and adjusted models (HR, 0.87; 95% CI, 0.77-0.97; P = .01). CONCLUSIONS: In comparison with cancerpatients who died in a hospital, cancerpatients who died at home had similar or longer survival. Cancer 2016;122:1453-1460.
Authors: Ahmed F Elsayem; Eduardo Bruera; Alan Valentine; Carla L Warneke; Geri L Wood; Sai-Ching J Yeung; Valda D Page; Julio Silvestre; Patricia A Brock; Knox H Todd Journal: Oncologist Date: 2017-08-01
Authors: Roberta I Jordan; Matthew J Allsop; Yousuf ElMokhallalati; Catriona E Jackson; Helen L Edwards; Emma J Chapman; Luc Deliens; Michael I Bennett Journal: BMC Med Date: 2020-11-26 Impact factor: 8.775