Remaining Lifetime After Recognition of Terminal Illness Depends on Diagnosis: A Nationwide Population-Based Cohort Study

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• 作者：Cathrine Bell ; MHSc^a ; ^cbel@feap.dk ; Mette K. Nielsen ; PhD ; MD^a ; Mette A. Neergaard ; PhD ; MD^b ; Mai-Britt Guldin ; PhD ; MD^a ; ^b ; Anders B. Jensen ; PhD ; MD^c
• 关键词：Remaining lifetime ; terminally ill ; diagnosis ; cancer ; noncancer ; cohort study
• 刊名：Journal of Pain and Symptom Management
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：53
• 期：1
• 页码：116-123
• 全文大小：462 K
• 卷排序：53

文摘

Timely recognition of the terminal phase of life will benefit patients and caregivers as it may facilitate advance care planning and support.ObjectivesThe objective of this study was to investigate the remaining lifetime of patients entering a physician-assessed terminal phase and to analyze variation in remaining lifetime according to diagnosis and sociodemographic factors.MethodsDanish National Health Registers were used to establish a prospective cohort of adult patients formally registered with drug reimbursement due to terminal illness in 2012 and followed until June 2014.ResultsOf the 11,062 included patients, the median remaining lifetime was 55 days and 37% of the patients died within the first month. The majority suffered from cancer (89%). Patients with a noncancer disease had the shortest remaining lifetime (17 days), considerably shorter than patients with cancer (59 days). Patients with prostate cancer had the longest remaining lifetime (76 days), whereas those with hematologic cancer had the shortest among cancer patients (41 days). Compared with lung cancer patients, the probability of death within 30 days were higher for patients with noncancer disease and lower for those with prostate or colorectal cancer. Male gender and high age were associated with higher risk of dying within 30 days.ConclusionThis study found a median remaining lifetime of 55 days after recognition of terminal illness. Remaining lifetime differed between cancer and noncancer patients and according to age and gender. Increased attention should be directed toward timely recognition of the transition into the terminal phase, especially for patients with noncancer disease.