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  • 1.
    Han, Hedong
    et al.
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Liu, Yuzhou
    Mount Sinai St Luke's and West Medical Center, New York, NY, USA.
    Qin, Yuchen
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Guo, Wei
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Ruan, Yiming
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Wu, Cheng
    Department of Health Statistics, Second Military Medical University, Shanghai, China.
    Cao, Yang
    Örebro universitet, Institutionen för medicinska vetenskaper. Region Örebro län.
    He, Jia
    Department of Health Statistics, Second Military Medical University, Shanghai, China; Tongji University School of Medicine, Shanghai, China.
    Utilization of Palliative Care for Patients Undergoing Hematopoietic Stem Cell Transplantation During Hospitalization: A Population-Based National Study2019Ingår i: The American Journal of Hospice and Palliative Medicine, ISSN 1049-9091, Vol. 36, nr 10, s. 900-906Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: Patients undergoing hematopoietic stem cell transplantation (HSCT) have substantial physical and psychological symptoms. This study aimed to investigate the utilization of palliative care (PC) in patients undergoing HSCT during hospitalization.

    METHODS: The 2008-2014 National Inpatient Sample was queried for eligible participants. Demographics, hospital characteristics, comorbidities, posttransplantation complications, and inpatient procedures were compared between patients with and without PC. Multivariate logistic regression was performed to identify predictors associated with PC use.

    RESULTS: Among 21 458 patients undergoing HSCT during hospitalization, 278 (1.30%) received PC. The rate of PC use has significantly increased from 0.64% in 2008 to 1.95% in 2014. Patients receiving PC had more co-comorbidities, posttransplantation complications, inpatient procedures, and were more likely to carry a diagnosis of leukemia. In allogeneic HSCT, large bed size (odds ratio [OR] =2.80; 95% confidence interval [CI]: 1.17-6.70), stem cell source from cord blood (OR = 1.93; 95% CI: 1.15-3.24), and graft-versus-host disease (OR = 2.04; 95% CI: 1.36-3.06) were predictors of PC use. In a subset analysis of 783 patients who died during hospitalization, 166 (21.20%) received PC. Among the decedents, Hispanic race had lower odds of PC use (OR = 0.20; 95% CI: 0.05-0.82) in allogeneic HSCT and women had higher odds of PC (OR = 2.70; 95% CI: 1.35-5.41) in autologous HSCT.

    CONCLUSIONS: The rate of PC use has significantly increased among patients undergoing HSCT during hospitalization from 2008 to 2014 but still remains very low. Further investigation is warranted to verify and better understand the barriers toward PC use for HSCT patients.

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