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Clinical, sociodemographic, and local system factors associated with a hospital death among cancer patients

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Abstract

Objective

The study was conducted to examine factors associated with hospital deaths among a group of cancer patients.

Patients and methods

A retrospective chart review of the M. D. Anderson Cancer Center Tumor Registry was conducted. Participants were all adult cancer patients, residents of the State of Texas diagnosed and treated since January 1, 1990, and who died during the years 1999 and 2000. The study outcome was the site of death.

Main results

The inclusion criteria were met by 866 patients of whom 504 (58%) died in a hospital. The group included 489 (56%) men. A number of 641 (74%) were White, 104 (12%) Hispanic, 92 (11%) Black, and 29 (3%) of other origin. The majority, 501 (58%), had been diagnosed with stage IV disease, and the median survival time was 14 months. Multivariate logistic regression analysis showed patients diagnosed with hematologic cancers to be significantly more likely (p<0.001) of dying in hospitals, odds ratio [OR 2.88] and confidence interval [95% CI 1.79–4.63], women diagnosed with breast and gynecological cancers were significantly less likely (p=0.03) of dying at hospitals odds ratio [OR 0.64] and confidence interval [95% CI 0.42–0.96], when compared with patients diagnosed with other cancers. Lower household income per zip code of residency was marginally associated (p=0.06) with hospital deaths.

Conclusions

The study identified groups of cancer patients at risk of hospital death. These results should account when planning the allocation of hospital palliative care services as well as when informing policy decisions about health care financing and delivery of these services.

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Acknowledgements

The authors wish to thank Charissa Higginbotham and Lore Feldman for their editorial contributions which enhanced the quality of this manuscript.

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Authors and Affiliations

  1. Section of Health Services Research, Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., P.O. Box 196, Houston, TX, 77030-4009, USA

    Marylou Cárdenas-Turanzas

  2. The University of Texas School of Public Health, 1200 Herman Pressler Dr., Houston, TX, 77030, USA

    Richard M. Grimes & Beth Quill

  3. Department of Palliative Care and Rehabilitation Medicine, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., P.O. Box 8, Houston, TX, 77030, USA

    Eduardo Bruera

  4. The University of Texas School of Public Health, 7000 Fannin St., Houston, TX, 77030, USA

    Guillermo Tortolero-Luna

Authors
  1. Marylou Cárdenas-Turanzas
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  2. Richard M. Grimes
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  3. Eduardo Bruera
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  4. Beth Quill
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  5. Guillermo Tortolero-Luna
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Corresponding author

Correspondence to Marylou Cárdenas-Turanzas.

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We want to state that no financial support was provided for this study

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Cárdenas-Turanzas, M., Grimes, R.M., Bruera, E. et al. Clinical, sociodemographic, and local system factors associated with a hospital death among cancer patients. Support Care Cancer 14, 71–77 (2006). https://doi.org/10.1007/s00520-005-0819-2

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  • DOI: https://doi.org/10.1007/s00520-005-0819-2

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