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- Title
Advanced Stage of Disease and Systemic Inflammation as Factors Associated With Referral of Patients With Colorectal Cancer to a Palliative Care Unit.
- Authors
Silva, Thiago Huaytalla; Peres, Wilza Arantes Ferreira; Rosa, Karla Santos da Costa; Schilithz, Arthur Orlando Correa; de Oliveira, Livia Costa; Murad, Leonardo Borges
- Abstract
Objective: To identify factors associated with referral to an exclusive palliative care unit (PCU) in patients with colorectal cancer (CRC). Methods: Retrospective cohort study with patients having CRC of both sexes treated at a hospital unit, aged ≥20 years. Data were extracted from the medical records of pretreatment patients between January 2008 and August 2014. The outcome was referral to the PCU within 5 years. Logistic regression analyses were performed to assess whether sociodemographic, clinical, nutritional, and biochemistry data were associated to referral, generating odds ratios (OR), and 95% confidence intervals (CI). Results: Four hundred fifteen patients were evaluated. The Patient-Generated Subjective Global Assessment demonstrated a prevalence of malnutrition of 57.3%. One hundred one (24.3%) patients were referred to the PCU after 16.3 months (interquartile range: 7.2-33.5). These patients were more likely to be at an advanced stage of the disease and have malnutrition and exacerbated systemic inflammation. Tumor stage III and IV (OR: 2.05; 95% CI: 1.12-3.76) and neutrophil-to-lymphocyte ratio (NLR) ≥3 (OR: 1.89; 95% CI: 1.12-3.17) were predictors of an increased chance of referral to the PCU. Conclusion: Advanced disease stage and NLR were associated with referral of patients with CCR to a PCU.
- Subjects
BRAZIL; MALNUTRITION; CANCER patients; COLON tumors; CONFIDENCE intervals; HOSPITAL wards; INFLAMMATION; LONGITUDINAL method; LYMPHOCYTES; MEDICAL referrals; MULTIVARIATE analysis; NEUTROPHILS; PALLIATIVE treatment; RECTUM tumors; STATISTICS; T-test (Statistics); LOGISTIC regression analysis; RETROSPECTIVE studies; SEVERITY of illness index; DATA analysis software; DESCRIPTIVE statistics; ODDS ratio; MANN Whitney U Test
- Publication
American Journal of Hospice & Palliative Medicine, 2020, Vol 37, Issue 10, p859
- ISSN
1049-9091
- Publication type
Article
- DOI
10.1177/1049909120902789