Hospice Utilization in Elderly Patients With Brain Metastases

Abstract Background Brain metastases are associated with considerable morbidity and mortality. Integration of hospice at the end of life offers patients symptom relief and improves quality of life, particularly for elderly patients who are less able to tolerate brain-directed therapy. Population-lev...

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Bibliographic Details
Published in:JNCI : Journal of the National Cancer Institute 2020-12, Vol.112 (12), p.1251-1258
Main Authors: Mehanna, Elie K, Catalano, Paul J, Cagney, Daniel N, Haas-Kogan, Daphne A, Alexander, Brian M, Tulsky, James A, Aizer, Ayal A
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Brain
Brain cancer
Brain Neoplasms - epidemiology
Brain Neoplasms - secondary
Brain Neoplasms - therapy
Confidence intervals
End of life
Enrollments
Epidemiology
Female
Government programs
Health Resources - statistics & numerical data
Hospice Care - statistics & numerical data
Hospices - statistics & numerical data
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Metastases
Metastasis
Morbidity
Older people
Patient Acceptance of Health Care - statistics & numerical data
Quality of life
SEER Program
Statistical analysis
Statistical tests
United States - epidemiology
Utilization
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Summary:Abstract Background Brain metastases are associated with considerable morbidity and mortality. Integration of hospice at the end of life offers patients symptom relief and improves quality of life, particularly for elderly patients who are less able to tolerate brain-directed therapy. Population-level investigations of hospice utilization among elderly patients with brain metastases are limited. Methods Using the Surveillance, Epidemiology and End Results–Medicare database for primary cancer sites that commonly metastasize to the brain, we identified 50 148 patients (aged 66 years and older) diagnosed with brain metastases between 2005 and 2016. We calculated the incidence, timing, and predictors of hospice enrollment using descriptive techniques and multivariable logistic regression. All statistical tests were 2-sided. Results The incidence of hospice enrollment was 71.4% (95% confidence interval [CI] = 71.0 to 71.9; P 
ISSN:0027-8874
1460-2105
DOI:10.1093/jnci/djaa036