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S. Anwar
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P1.11 - Poster Session/ Palliative and Supportive Care (ID 229)
- Event: WCLC 2015
- Type: Poster
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.11-013 - Place and Cause of Death in Patients with Lung Cancer in the United Kingdom (ID 2735)
09:30 - 09:30 | Author(s): S. Anwar
- Abstract
Background:
Many patients with cancer die in an acute hospital bed, which has been frequently identified as the least preferred location, with psychological and financial implications. This study aims to look at place and cause of death in patients with lung cancer to identify which factors are associated with dying in an acute hospital bed versus at home.
Methods:
We used data from the National Lung Cancer Audit (NLCA) linked to Hospital Episode Statistics (HES) and Office of National Statistics (ONS) records to determine cause and place of death in those with lung cancer overall. England was divided into 28 cancer Networks at the time these data were collected so we used these to assess geographical variation in place of death. We used multivariate logistic regression to compare demographic, co-morbid and tumour-related factors between those who died in an acute hospital versus those who died at home.
Results:
Of 143627 patients identified 40% (57678) died in an acute hospital, 29% (41957) died at home and 17% (24108) died in a hospice. Individual factors strongly associated with death in an acute hospital bed compared to home were male sex, increasing age, poor performance status, social deprivation and diagnosis via an emergency route (table 1). There was marked variation between cancer Networks in place of death. The proportion of patients dying in an acute hospital ranged from 28% to 48%, with variation most notable in provision of hospice care (9% versus 33%). Cause of death in the majority was lung cancer (86%), with other malignancies, chronic obstructive pulmonary disease (COPD) and ischaemic heart disease (IHD) comprising 9% collectively.
Conclusion:
A substantial proportion of patients with lung cancer die in acute hospital beds and this is more likely with increasing age, male sex, social deprivation and in those with poor performance status. There is marked variation between Networks, suggesting a need to improve end-of-life planning in those at greatest risk, and to review the allocation of resources to provide more hospice beds, enhanced community support and ensure equal access. Figure 1
