Understanding patterns and factors associated with place of death in patients with end-stage kidney disease: A retrospective cohort study

Background: Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. Aim: To understand patterns of place of death in...

Full description

Saved in:
Bibliographic Details
Published in:Palliative medicine 2017-03, Vol.31 (3), p.283-288
Main Authors: Lovell, Natasha, Jones, Chris, Baynes, Dawn, Dinning, Sarah, Vinen, Katie, Murtagh, Fliss EM
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Attitude to Death
Cohort analysis
Confidence intervals
Death & dying
Deviation
Dialysis
End of life decisions
Female
Home Care Services - organization & administration
Home health care
Hospice care
Hospice Care - psychology
Humans
Inpatient care
Kidney diseases
Kidney Failure, Chronic - therapy
Living alone
Male
Odds Ratio
Palliative care
Palliative Care - psychology
Patient Preference - psychology
Patient Preference - statistics & numerical data
Patients rights
Place of death
Quantitative analysis
Renal Dialysis
Residence
Retrospective Studies
Short Reports
Systematic review
Terminal Care - psychology
United Kingdom
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background: Meeting place-of-death preferences is an important measure of the quality of end-of-life care. Systematic review shows that 42% of end-stage kidney disease patients prefer home death. Little research has been undertaken on place of death. Aim: To understand patterns of place of death in patients with end-stage kidney disease known in one UK renal unit. Design: A retrospective cohort study of all patients with chronic kidney disease stage 4–5, age ⩾75 and known to one UK renal unit, who died between 2006 and 2012. Patients were categorised into three management pathways: haemodialysis, conservative and pre-dialysis. Results: A total of 321 patients (mean age, 82.7; standard deviation, 5.21) died (61.7% male). In all, 62.9% died in hospital (95% confidence interval, 57.5%–68.1%), 21.8% died in their usual place of residence (95% confidence interval, 17.5%–26.6%) and 15.3% died in an inpatient palliative care unit (95% confidence interval, 11.6%–19.5%). Management pathway and living circumstances were most strongly associated with place of death. Patients on the conservative pathway had four times the odds of dying out of hospital (odds ratio, 4.0; 95% confidence interval, 2.1–7.5; p 
ISSN:0269-2163
1477-030X
DOI:10.1177/0269216316655747