Palliative Care Consultation for Hospitalized Patients with Primary and Secondary Brain Tumors at a Single Academic Center.

Abstract

<b><i>Introduction:</i></b> Studies addressing palliative care delivery in neuro-oncology are limited. <b><i>Objectives:</i></b> To compare inpatients with brain tumors who received palliative care (through referral or trigger) with those receiving usual care. <b><i>Design:</i></b> Retrospective cohort study. <b><i>Setting/Subjects:</i></b> Inpatients with primary or secondary brain tumors who did or did not receive palliative care at a U.S. medical center. <b><i>Measurements:</i></b> Sociodemographic, clinical, and utilization characteristics were compared. <b><i>Results:</i></b> Of 1669 brain tumor patients, 386 (23.1%) received palliative care [nontrigger: 246 (14.7%); trigger: 140 (8.4%)] and 1283 (76.9%) received usual care. Nontrigger patients were oldest (mean age 65.0 years; trigger: 61.1 years; usual care: 55.5 years; <i>p</i> < 0.001); sickest at baseline (mean Elixhauser comorbidity index 3.76; trigger: 3.49; usual care: 1.84; <i>p</i> < 0.001); and had highest in-hospital death [34 (13.8%), trigger: 10 (7.1%), usual care: 7 (0.5%); <i>p</i> < 0.001] and hospice discharge [54 (22.0%), trigger: 18 (12.9%), usual care: 14 (1.1%); <i>p</i> < 0.001]. <b><i>Conclusions:</i></b> Trigger criteria may promote earlier palliative care referral, yet criteria tailored for neuro-oncology are undeveloped.