Association between the duration of palliative care service and survival in terminal cancer patients
Menée en République de Corée à partir des données de 609 patients atteints de cancer en phase terminale et décédés sur la période 2010-2012, cette étude évalue l'association entre la durée de leur prise en charge dans des services hospitaliers de soins palliatifs et leur survie
Purpose : Preliminary studies of early palliative care showed improved quality of life, less medical cost, and better survival time. But, most terminal cancer patients tend to be referred to palliative care late. For the proper care of terminal cancer patients, it is necessary to refer to hospice and palliative care timely. The aim of this study is to analyze the effect of the duration of palliative care services on the survival in terminal cancer patients. Methods : We reviewed 609 patients who had died from terminal cancer between January 2010 and December 2012. We analyzed correlations of age, first Palliative Performance Scale (PPS) level, duration of palliative care service, and survival time. The Cox proportional hazards regression model was used for both univariate and multivariate analyses of survival. Results : Duration of palliative care services was significantly correlated with survival time. In univariate Cox regression analysis, age, and each group of duration of palliative care service showed significant associations with survival. Final multivariate Cox regression model retained four parameters as independent prognostic factors for survival (age HR = 0.99 (p = 0.002), 1∼10 days HR = 2.64 (p < 0.001), 11∼30 days HR = 2.43 (p < 0.001), 31∼90 days HR = 1.87 (p < 0.001)). Conclusions : Shorter duration of palliative care services showed poor prognostic factor. Timely referral system from the end of chemotherapy is warranted.