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Kidney Week

Abstract: PO2170

Temporal Trends of Palliative Care Use Among Hospitalized Patients with Metastatic Renal Cell Carcinoma

Session Information

  • Onco-Nephrology - 1
    October 22, 2020 | Location: On-Demand
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Li, Si, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Wang, Yichen, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Zhuo, Min, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States
  • Wang, Qiyu O., Cook County Health and Hospitals system, Chicago, Illinois, United States
  • Elavia, Nasha, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Sharma, Nishant, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
  • Milekic, Bojana, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, United States
Background

Patients with metastatic renal cell carcinoma have a poor prognosis and they may suffer from hypercalcemia, venous thromboembolism, anorexia-cachexia syndrome. Little is known about the trends in the utilization of palliative care in this patient population.

Methods

We conducted a retrospective cohort study using data from 2004 to 2014, which were extracted from the National Inpatient Sample. ICD-9-CM was used to identify all diagnosis variables. We compared the baseline demographics. We assessed the annual trend over time in palliative care utilization rates. Statistical analysis was performed using STATA 16.0. We considered a two-tailed P value of <0.05 as statistically significant.

Results

We identified 181,199 hospitalizations with metastatic renal cell carcinoma from 2004 through 2014, of which 16,390 (9.0%) involved palliative care services. Inpatient palliative care utilization increased from 2.8% in 2004 to 16.3% in 2014 (p<0.001). Compared with patients discharged from non-teaching hospitals, we noticed a significantly higher rate of palliative care utilization in patients discharged from teaching hospitals [aOR 1.46; 95% CI 1.29 to 1.65]. There were higher odds of receiving palliative care in patients with private insurance (aOR 1.26; 95% CI 1.11 to 1.42). We also observed lower odds of receiving palliative care in Hispanic patients (aOR 0.83; 95% CI 0.70 to 0.98, p=0.03).

Conclusion

The rate of inpatient palliative care use in metastatic renal cell carcinoma patients sharply increased between 2004 and 2014. Our findings demonstrated improving adherence to the National comprehensive cancer network (NCCN) guidelines, which is highly encouraging. Patients from teaching hospitals and using private insurance and were more likely to receive palliative care.