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Title: Differences in place of death between lung cancer and COPD patients: a 14-country study using death certificate data.
Authors: Cohen, Joachim
Beernaert, Kim
Van den Block, Lieve
Morin, Lucas
Hunt, Katherine
Miccinesi, Guido
Cardenas-Turanzas, Marylou
Onwuteaka-Philipsen, Bregje
MacLeod, Rod
Ruiz-Ramos, Miguel
Wilson, Donna M
Loucka, Martin
Csikos, Agnes
Rhee, Yong-Joo
Teno, Joan
Ko, Winne
Deliens, Luc
Houttekier, Dirk
metadata.dc.subject.mesh: Adolescent
Aged, 80 and over
Death Certificates
Home Care Services
Logistic Models
Lung Neoplasms
Marital Status
Middle Aged
Multivariate Analysis
New Zealand
North America
Palliative Care
Pulmonary Disease, Chronic Obstructive
Republic of Korea
Terminal Care
Young Adult
Issue Date: 3-Mar-2017
Abstract: Chronic obstructive pulmonary disease and lung cancer are leading causes of death with comparable symptoms at the end of life. Cross-national comparisons of place of death, as an important outcome of terminal care, between people dying from chronic obstructive pulmonary disease and lung cancer have not been studied before. We collected population death certificate data from 14 countries (year: 2008), covering place of death, underlying cause of death, and demographic information. We included patients dying from lung cancer or chronic obstructive pulmonary disease and used descriptive statistics and multivariable logistic regressions to describe patterns in place of death. Of 5,568,827 deaths, 5.8% were from lung cancer and 4.4% from chronic obstructive pulmonary disease. Among lung cancer decedents, home deaths ranged from 12.5% in South Korea to 57.1% in Mexico, while hospital deaths ranged from 27.5% in New Zealand to 77.4% in France. In chronic obstructive pulmonary disease patients, the proportion dying at home ranged from 10.4% in Canada to 55.4% in Mexico, while hospital deaths ranged from 41.8% in Mexico to 78.9% in South Korea. Controlling for age, sex, and marital status, patients with chronic obstructive pulmonary disease were significantly less likely die at home rather than in hospital in nine countries. Our study found in almost all countries that those dying from chronic obstructive pulmonary disease as compared with those from lung cancer are less likely to die at home and at a palliative care institution and more likely to die in a hospital or a nursing home. This might be due to less predictable disease trajectories and prognosis of death in chronic obstructive pulmonary disease. IMPROVING END-OF-LIFE CARE: Structured palliative care similar to that offered to cancer sufferers should be in place for patients with chronic lung disease. Joachim Cohen at Vrije University in Brussels and co-workers examined international death certificate data collected from 14 countries to determine place of death for patients with lung cancer and chronic obstructive pulmonary disease (COPD). While patients with COPD suffer similar symptoms to lung cancer in their final days, few COPD patients receive palliative care or achieve the common wish of dying at home. This may be partly due to the inherent unpredictability of final-stage COPD compared with lung cancer. Cohen's team found that, with the exception of Italy, Spain, and Mexico, patients with COPD were significantly more likely to die in hospital than at home. They highlight the need for improved COPD palliative care provision.
metadata.dc.identifier.doi: 10.1038/s41533-017-0017-y
Appears in Collections:Producción 2020

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