Wednesday, July 04, 2007
Complications at the End of Life in Ovarian Cancer. [J Pain Symptom Manage. 2007] - PubMed Result
J Pain Symptom Manage. 2007 Jun 30; [Epub ahead of print]
Complications at the End of Life in Ovarian Cancer.
Herrinton LJ, Neslund-Dudas C, Rolnick SJ, Hornbrook MC, Bachman DJ, Darbinian JA, Jackson JM, Coughlin SS.
Division of Research (L.J.H., J.A.D.), Kaiser Permanente Northern California, Oakland, California; Henry Ford Health Systems (C.N.-D.), Detroit, Michigan; HealthPartners Research Foundation (S.J.R., J.M.J.), Minneapolis, Minnesota; Center for Health Research, Northwest/Hawaii (M.C.H., D.J.B.), Kaiser Permanente Northwest, Portland, Oregon; and Division of Cancer Prevention and Control (S.S.C.), United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Women dying of ovarian cancer vary considerably in their complications and in the types of health care they receive. The objective of this study was to describe the complications of ovarian cancer, other than pain, and their treatment at the end of life. This study used a cohort of 421 enrollees in three nonprofit managed-care organizations who died with ovarian cancer during 1995-2000. Data were collected from abstraction of paper and electronic medical records. Proportions of women experiencing complications and undergoing treatments were calculated. Logistic regression was used to evaluate the association of patient characteristics with the probability of receiving an intervention for complications. The most common complications recorded in the medical record were fatigue or weakness (75%), nausea or vomiting (71%), constipation (49%), edema of the extremities (44%), and anemia (34%). The prevalence of major complications was as follows: ascites, 28%; bowel obstruction, 12%; pleural effusion, 10%; bladder obstruction, 3%; and disordered nutrition that required support with parenteral nutrition, 9%. Patients may not always have received interventions for major complications; for example, pleural effusion apparently was left untreated in almost half of the women with this problem. After adjustment, women who died at younger ages were more likely to receive an intervention, compared to older women (odds ratio for each decade of age, 0.71, 95% confidence interval=0.53-0.94, P for trend=0.02). The study, which preceded the establishment of palliative care programs, suggests that care given to ovarian cancer patients at the end of life may be inadequate.
PMID: 17606360 [PubMed - as supplied by publisher]
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