Assessing the utilization of the decision to implement a palliative goal for the treatment of cancer patients during the last year of life at Helsinki University Hospital: a historic cohort study

Figures & data

Table 1. Characteristics of the patient population.

Characteristic
Gender, n (%)	Male 499 (52.6%)
	Female 450 (47.4%)
Palliative care decision made, N (%)	773 (81%)
	Median	IQR
Age at death (years)	68 y	61–75 y
Time from diagnosis to death	539 d	243–1133 d
	(19 mos)	(8–38 mos)
Time from diagnosis to palliative care decision	443 d	153–1057 d
	(15 mos)	(5–35 mos)
Time from the palliative care decision to death	46 d	16–131 d
	(1.5 mos)	(0.5–4.5 mos)
Time from the last systemic cancer treatment to death	78 d	37–155 d
	(2.6 mos)	(1.2–5.1 mos)
Time from the last dose of radiotherapy to death	74 d	27–174 d
	(2.5 mos)	(0.9–5.8 mos)

M: male; F: female; IQR: interquartile range; y: years; d: days; mos: months

Table 2. Time from palliative care decision to death in different cancer groups.

Cancer diagnosis	Time from the palliative care decision to death			N (% from total)
	>30 d	≤30 d	No decision
Head and neck	36%	36%	29%	28 (3%)
Upper gastrointestinal	55%	32%	14%	218 (23%)
Colorectal	61%	25%	14%	123 (13%)
Lung^a	47%	31%	23%	118 (12%)
Melanoma and other skin cancers	38%	44%	19%	32 (3%)
Breast	31%	46%	23%	106 (11%)
Gynecological^a	36%	32%	32%	28 (3%)
Prostate	57%	24%	19%	67 (7%)
Sarcomas	60%	23%	17%	30 (3%)
Urinary tract	52%	38%	10%	61 (6%)
Primary CNS malignancies	45%	28%	27%	60 (6%)
Lymphomas	41%	43%	16%	37 (4%)
Others	41%	34%	24%	41 (4%)
TOTAL	416	312	176	949

^a Only patients receiving radiotherapy are included.

Table 3. Time from PC decision to death in different age groups.

Age group	>30 days, % (n)	≤30 days, % (n)	No decision, % (n)	Mean, days (SD)
20–40 years	36% (12)	39% (13)	24% (8)	78 d (120.3)
41–60 years	42% (85)	35% (72)	23% (46)	100 d (182.7)
61–70 years	46% (152)	32% (109)	22% (72)	95 d (150.4)
71–80 years	51% (136)	33% (88)	16% (42)	110 d (168.5)
>80 years^a	67% (76)	26% (30)	7% (8)	165 d (259.6)
TOTAL	49% (461)	33% (312)	19% (176)	109 d (180.9)

^a Statistically significant (p < .05) difference with other age groups.

Table 4. Characteristics associated with a PC decision made > 30 days before death in the logistic regression model: odds ratios and confidence intervals.

Characteristics	Odds ratios	95% CI	p Value
Diagnoses
Breast cancer (ref)	1
Sarcomas	5.2	2.11–12.59	<.001
Colorectal cancers	4.3	2.37–7.81	<.001
Upper gastrointestinal (GI) cancers	3.5	1.97–6.06	<.001
Prostate cancer	2.9	1.50–5.63	<.001
Cancers of urinary tract	2.9	1.43–5.69	.003
Primary CNS malignancies	2.8	1.38–5.73	.004
Lung cancer	2.5	1.35–4.61	.004
Others	2.0	0.91–4.41	.084
Lymphomas	1.9	0.85–4.42	.115
Gynecological cancers	1.8	0.70–4.46	.230
Head & Neck cancers	1.8	0.70–4.42	.228
Melanoma and other skin cancers	1.6	0.66–3.66	.318
Age (standardized)	1.3	1.16–1.54	<.001
Time from diagnosis to death (standardized)	1.2	1.02–1.39	.03

Breast cancer diagnosis is used as the reference value for the diagnosis variable.

Figure 1. Time between last radiation therapy and death (a) and time between last systemic cancer treatment and death (b) with respect to the timing of the PC decision.