Trends in the Utilization of Life-Sustaining Procedures and Palliative Care Consultation Among Dying Patients With Advanced Chronic Pancreas Illnesses in US Hospitals: 2005 to 2014

Xibei Liu, Jay J. Shen, Pearl Kim, Sun Jung Kim, Johnson Ukken, Younseon Choi, In Choel Hwang, Jae Hoon Lee, Sung Youn Chun, Jinwook Hwang, Haneul Choi, Hyeyoung Yeom, Yong Jae Lee, Ji Won Yoo

Research output: Contribution to journalArticle

Abstract

Aim: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. Methods and Materials: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. Results: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were −4.19% (P =.008), 2.17%, −1.40%, and 14.03% (P <.001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation (Ps <.001). Conclusions: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.

Original languageEnglish
Pages (from-to)232-240
Number of pages9
JournalJournal of Palliative Care
Volume34
Issue number4
DOIs
Publication statusPublished - 2019 Oct 1

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Palliative Care
Pancreas
Chronic Disease
Referral and Consultation
Odds Ratio
Confidence Intervals
Pancreatic Neoplasms
Growth
Inpatients
Hospitalization
Cross-Sectional Studies
Logistic Models
Databases

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Liu, Xibei ; Shen, Jay J. ; Kim, Pearl ; Kim, Sun Jung ; Ukken, Johnson ; Choi, Younseon ; Hwang, In Choel ; Lee, Jae Hoon ; Chun, Sung Youn ; Hwang, Jinwook ; Choi, Haneul ; Yeom, Hyeyoung ; Lee, Yong Jae ; Yoo, Ji Won. / Trends in the Utilization of Life-Sustaining Procedures and Palliative Care Consultation Among Dying Patients With Advanced Chronic Pancreas Illnesses in US Hospitals : 2005 to 2014. In: Journal of Palliative Care. 2019 ; Vol. 34, No. 4. pp. 232-240.
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abstract = "Aim: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. Methods and Materials: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. Results: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were −4.19{\%} (P =.008), 2.17{\%}, −1.40{\%}, and 14.03{\%} (P <.001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95{\%} confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95{\%} CI, 1.27-1.70), and surgeries (OR = 2.51, 95{\%} CI, 2.07-3.05) was associated with palliative care consultation (Ps <.001). Conclusions: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.",
author = "Xibei Liu and Shen, {Jay J.} and Pearl Kim and Kim, {Sun Jung} and Johnson Ukken and Younseon Choi and Hwang, {In Choel} and Lee, {Jae Hoon} and Chun, {Sung Youn} and Jinwook Hwang and Haneul Choi and Hyeyoung Yeom and Lee, {Yong Jae} and Yoo, {Ji Won}",
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Trends in the Utilization of Life-Sustaining Procedures and Palliative Care Consultation Among Dying Patients With Advanced Chronic Pancreas Illnesses in US Hospitals : 2005 to 2014. / Liu, Xibei; Shen, Jay J.; Kim, Pearl; Kim, Sun Jung; Ukken, Johnson; Choi, Younseon; Hwang, In Choel; Lee, Jae Hoon; Chun, Sung Youn; Hwang, Jinwook; Choi, Haneul; Yeom, Hyeyoung; Lee, Yong Jae; Yoo, Ji Won.

In: Journal of Palliative Care, Vol. 34, No. 4, 01.10.2019, p. 232-240.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Trends in the Utilization of Life-Sustaining Procedures and Palliative Care Consultation Among Dying Patients With Advanced Chronic Pancreas Illnesses in US Hospitals

T2 - 2005 to 2014

AU - Liu, Xibei

AU - Shen, Jay J.

AU - Kim, Pearl

AU - Kim, Sun Jung

AU - Ukken, Johnson

AU - Choi, Younseon

AU - Hwang, In Choel

AU - Lee, Jae Hoon

AU - Chun, Sung Youn

AU - Hwang, Jinwook

AU - Choi, Haneul

AU - Yeom, Hyeyoung

AU - Lee, Yong Jae

AU - Yoo, Ji Won

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Aim: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. Methods and Materials: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. Results: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were −4.19% (P =.008), 2.17%, −1.40%, and 14.03% (P <.001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation (Ps <.001). Conclusions: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.

AB - Aim: Pancreas cancer continues to carry a poor prognosis. Hospitalized patients with advanced chronic pancreatic illnesses increasingly receive palliative care due to its perceived clinical benefits. Meanwhile, a growing proportion of elderly patients are reportedly receiving life-sustaining procedures. Temporal trends in the utilization of life-sustaining procedures and palliative care consultation among dying patients with advanced chronic pancreatic illnesses in US hospitals were examined. Methods and Materials: A serial, cross-sectional analysis was carried out using the National Inpatient Sample Database. Decedents 18 years and older with a principal diagnosis of pancreas cancer or other advanced chronic pancreatic illnesses from 2005 through 2014. The compound annual growth rates (CAGRs) and Cochrane-Armitage correction of χ2 statistic were used. The receipt of life-sustaining systemic procedures, intra-abdominal local procedures and surgeries, and palliative care consultation were examined. Multilevel multivariate logistic regressions were performed to examine the association of various procedures with the utilization of palliative care consultation. Results: Among 77 394 183 hospitalizations, 29 515 patients were examined. The CAGRs of systemic procedures, intra-abdominal procedures, surgeries, and palliative care were −4.19% (P =.008), 2.17%, −1.40%, and 14.03% (P <.001), respectively. The receipt of systemic procedures (odds ratio [OR] = 2.40, 95% confidence interval [CI], 2.08-2.74), local intra-abdominal procedures (OR = 1.46, 95% CI, 1.27-1.70), and surgeries (OR = 2.51, 95% CI, 2.07-3.05) was associated with palliative care consultation (Ps <.001). Conclusions: Among adults with pancreatic cancer or other advanced chronic pancreatic illnesses in the US hospitals from 2005 to 2014, the utilization of life-sustaining systemic procedures decreased while the prevalence of palliative care consultation increased.

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