PMID- 30371986
OWN - NLM
STAT- MEDLINE
DCOM- 20200312
LR  - 20200312
IS  - 1464-410X (Electronic)
IS  - 1464-4096 (Linking)
VI  - 123 Suppl 5
DP  - 2019 May
TI  - The trajectory of patients who die from metastatic prostate cancer: a 
      population-based study.
PG  - 19-26
LID - 10.1111/bju.14593 [doi]
AB  - OBJECTIVES: To describe health service use, symptom and survival characteristics 
      in metastatic prostate cancer (mPCa) in order to outline usual care practices and 
      identify future opportunities to improve the quality of care in this patient 
      group. PATIENTS AND METHODS: This population cohort study, conducted in Victoria, 
      Australia, used 10 years (2000-2010) of linked hospital discharge, emergency 
      visit, and death registration data, to track patients from their first inpatient 
      admission with mPCa until death. Descriptive statistics on inpatient health 
      service use, symptoms, procedures, survival, and place of death are presented. 
      RESULTS: In all, 4436 patients survived a median (interquartile range [IQR]) of 
      4 (1, 12) months from their first multiday admission with mPCa. They had a median 
      (IQR) of 3 (1, 9) admissions, 1 (0, 2) emergency department presentation, and 
      35 (18, 63) days admitted to hospital. Lower urinary tract symptoms were common 
      (50%), and 21% underwent lower urinary tract procedures, whilst 48% had blood 
      product transfusions. In the last month of life, 3685 (83%) had at least one 
      indicator of aggressive end-of-life care, including 48% with more than one acute 
      hospital admission, and 55% staying >/=14 days. Hospital-based palliative care was 
      accessed by 2657 (60%), occurring a median (IQR) of 30 (11, 74) days before 
      death. In all, 23% died in the community, whilst 77% died in hospital, of whom 
      55% died in an acute hospital bed. CONCLUSION: Half of all decedents first 
      admitted for a multiday stay with mPCa survived <4 months thereafter. They had a 
      marked symptom burden, underwent multiple procedures and had multiple admissions. 
      In all, 40% of patients did not receive any hospital-based palliative care. 
      Several opportunities exist to improve the timely transition to palliative care 
      services with mPCa. These data form a benchmark against which future improvements 
      to palliative care integration may be measured.
CI  - (c) 2018 The Authors BJU International (c) 2018 BJU International Published by John 
      Wiley & Sons Ltd.
FAU - Collins, Anna
AU  - Collins A
AUID- ORCID: 0000-0003-2139-0100
AD  - Department of Medicine, St Vincent's Hospital, University of Melbourne, 
      Melbourne, Vic., Australia.
FAU - Sundararajan, Vijaya
AU  - Sundararajan V
AD  - Department of Medicine, St Vincent's Hospital, University of Melbourne, 
      Melbourne, Vic., Australia.
AD  - Department of Public Health, La Trobe University, Melbourne, Vic., Australia.
FAU - Millar, Jeremy
AU  - Millar J
AD  - Radiation Oncology, Alfred Health, Melbourne, Vic., Australia.
FAU - Burchell, Jodie
AU  - Burchell J
AD  - Department of Medicine, St Vincent's Hospital, University of Melbourne, 
      Melbourne, Vic., Australia.
FAU - Le, Brian
AU  - Le B
AD  - Parkville Integrated Palliative Care Service, Victorian Comprehensive Cancer 
      Centre, Melbourne, Vic., Australia.
FAU - Krishnasamy, Mei
AU  - Krishnasamy M
AD  - Department of Nursing, University of Melbourne, Melbourne, Vic., Australia.
FAU - McLachlan, Sue-Anne
AU  - McLachlan SA
AD  - Medical Oncology, St Vincent's Hospital, Melbourne, Vic., Australia.
FAU - Hudson, Peter
AU  - Hudson P
AD  - Centre for Palliative Care, St Vincent's Hospital Melbourne, University of 
      Melbourne, Melbourne, Vic., Australia.
AD  - Vrije University, Brussels, Belgium.
FAU - Mileshkin, Linda
AU  - Mileshkin L
AD  - Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.
FAU - Philip, Jennifer
AU  - Philip J
AD  - Department of Medicine, St Vincent's Hospital, University of Melbourne, 
      Melbourne, Vic., Australia.
AD  - Parkville Integrated Palliative Care Service, Victorian Comprehensive Cancer 
      Centre, Melbourne, Vic., Australia.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20181125
PL  - England
TA  - BJU Int
JT  - BJU international
JID - 100886721
SB  - IM
MH  - Aged
MH  - Cost of Illness
MH  - Emergency Service, Hospital/*statistics & numerical data
MH  - Facilities and Services Utilization
MH  - Health Services Accessibility
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Palliative Care/standards/statistics & numerical data
MH  - Prostatic Neoplasms/*mortality/*pathology/therapy
MH  - Terminal Care/standards/*statistics & numerical data
MH  - Victoria/epidemiology
OTO - NOTNLM
OT  - #PCSM
OT  - #ProstateCancer
OT  - #uroonc
OT  - end-of-life care
OT  - procedures
OT  - symptoms
EDAT- 2018/10/30 06:00
MHDA- 2020/03/13 06:00
CRDT- 2018/10/30 06:00
PHST- 2018/10/30 06:00 [pubmed]
PHST- 2020/03/13 06:00 [medline]
PHST- 2018/10/30 06:00 [entrez]
AID - 10.1111/bju.14593 [doi]
PST - ppublish
SO  - BJU Int. 2019 May;123 Suppl 5:19-26. doi: 10.1111/bju.14593. Epub 2018 Nov 25.