Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
Palliative care involvement and use of critical care therapies in patients with advanced cancer: a multicenter retrospective cohort study.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Monzón Verónica, Di Stefano Sabrina, Gira Alicia Roxana, Pratesi Pablo, Lagos Tomás, Najun Matías, Pochettino Melina, Leone Bruno, Ivulich Daniel, Huerta Hellen, Román Luis Alberto Vélez, Vaena Mariana, Olaizola Gustavo, Bellone Estefanía, de Andes Álvaro Pérez, Nagourney Jason, Huespe Iván, Bauque Susana, Osatnik Javier
Аннотация
BACKGROUND: Cancer is a leading cause of mortality worldwide, and a substantial proportion of patients with advanced disease require ICU admission, where decisions regarding critical care therapies are complex. Despite recommendations for early palliative care integration, its implementation in ICU settings remains limited.
AIM: To evaluate the association between palliative care involvement and the use of critical care therapies among critically ill patients with advanced solid tumors and in-hospital mortality.
DESIGN: Multicenter retrospective cohort study.
SETTING AND PARTICIPANTS: We included 292 adult patients with advanced solid tumors admitted to the ICU at three tertiary hospitals in Argentina between 2010 and 2024 who died during hospitalization. Patients were categorized according to palliative care involvement before or during ICU admission.
RESULTS: Overall, 23% of patients (95% CI, 19-29) received palliative care, including 18% (95% CI, 13-22) prior to ICU admission. Use of critical care therapies was lower among patients receiving palliative care compared with those who did not (54% vs. 72%; p < 0.01). After inverse probability weighting, palliative care involvement remained independently associated with lower odds of receiving critical care therapies (adjusted OR, 0.46; 95% CI, 0.33-0.66; p < 0.01). Hospital length of stay was shorter in the palliative care group (adjusted IRR, 0.67; 95% CI, 0.57-0.78; p < 0.01).
CONCLUSIONS: In this multicenter cohort of critically ill patients with advanced solid tumors, palliative care involvement was independently associated with reduced use of critical care therapies (including invasive mechanical ventilation, dialysis, parenteral nutrition, or tracheostomy) and shorter hospital length of stay, supporting its role in facilitating goal-concordant care.
AIM: To evaluate the association between palliative care involvement and the use of critical care therapies among critically ill patients with advanced solid tumors and in-hospital mortality.
DESIGN: Multicenter retrospective cohort study.
SETTING AND PARTICIPANTS: We included 292 adult patients with advanced solid tumors admitted to the ICU at three tertiary hospitals in Argentina between 2010 and 2024 who died during hospitalization. Patients were categorized according to palliative care involvement before or during ICU admission.
RESULTS: Overall, 23% of patients (95% CI, 19-29) received palliative care, including 18% (95% CI, 13-22) prior to ICU admission. Use of critical care therapies was lower among patients receiving palliative care compared with those who did not (54% vs. 72%; p < 0.01). After inverse probability weighting, palliative care involvement remained independently associated with lower odds of receiving critical care therapies (adjusted OR, 0.46; 95% CI, 0.33-0.66; p < 0.01). Hospital length of stay was shorter in the palliative care group (adjusted IRR, 0.67; 95% CI, 0.57-0.78; p < 0.01).
CONCLUSIONS: In this multicenter cohort of critically ill patients with advanced solid tumors, palliative care involvement was independently associated with reduced use of critical care therapies (including invasive mechanical ventilation, dialysis, parenteral nutrition, or tracheostomy) and shorter hospital length of stay, supporting its role in facilitating goal-concordant care.