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• W2912209573 abstract "Introduction: A recent report found that more Medicare beneficiaries use intensive care unit care at the end of life. This has been cited as evidence that people dying in U.S. hospitals are receiving more intensive medical intensive procedures. This study is to examine the temporal trends in the use of intensive medical procedures and palliative care during terminal hospitalization of patients with pancreatic cancer. Methods: A retrospective nationwide cohort analysis was performed, using the National Inpatient Sample (NIS) between years 2010 and 2014. All patients ≥ 18 years of age and descendants with a principal diagnosis of pancreatic cancer were included. Survey weights were applied from the NIS to provide national population estimates. Systemic support procedures were defined as life-sustaining treatments: (1) intubation, (2) invasive ventilation, (3) non-invasive mechanical ventilation, (4) enteral infusion, (5) parenteral infusion, (6) cardiopulmonary resuscitation, (7) blood transfusion, (8) hemodialysis; local procedures analyzed included (1) endoscopic retrograde cholangiopancreatography (ERCP), (2) percutaneous transhepatic biliary drainage (PTBD), (3) endoscopy, (4) percutaneous gastro (jejunostomy), (5) percutaneous abdominal drainage (paracentesis), using the International Classification of Diseases, 9th revision, Clinical Modification. Palliative care consultation and Do-Not-Resuscitate (DNR) data were also compared. We analyzed temporal trends by using Rao-Scott chi-square analysis between each procedure (or palliative care) and each year. Results: A total of 37,312,324 hospitalizations were examined. There were 13,648 weighted patients with pancreatic cancer. There were temporal trends of increasing procedure-free status (not receiving any type of procedure) in systemic support procedure (p =.048), mainly by decreasing utilization of blood transfusion (p =.026). Local procedure utilization was unchanging over time. There were also increasing palliative care consultation and DNR status in patients with pancreatic cancer (p < .0001 for both). Conclusion: Among adults who died from pancreatic cancer in the U.S. hospitals from year 2010 to 2014, temporal trends showed decreasing systemic support procedures, mainly by decreasing blood transfusion utilization. Reciprocally, palliative care utilization was rising.FigureTable: Table. Temporal trends of procedures, procedure-free status, and palliative care in patients with pancreatic cancer" @default.
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• W2912209573 date "2017-10-01" @default.
• W2912209573 modified "2023-09-27" @default.
• W2912209573 title "National Temporal Trends of Intensive Medical Procedures and Palliative Care During Terminal Hospitalization Among Patients With Pancreatic Cancer in the U.S." @default.
• W2912209573 doi "https://doi.org/10.14309/00000434-201710001-01156" @default.
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