Descriptive study of the therapeutic aggressiveness in oncology patients in the hospital area of Huelva.

Abstract

e18645 Background: The therapeutic aggressiveness (TA) criteria or Earle criteria (EC) (Table) explore indicators that reflect the quality of end-of-life cancer patients (pts). They are considered the gold standard to evaluate TA. The aim of our study is to analyze TA by applying EC in deceased cancer patients (pts) in the hospital area of Huelva. Methods: Observational and descriptive study of deceased cancer pts in the area of Juan Ramón Jiménez (HJRJ) and Vázquez Díaz (HVD) hospitals (2017– 2019). We used the IBM SPSS Statistics 22 program to analyze the overuse of oncology therapies (OT) and invasive therapies near death, as well as underutilization of hospice services (HS). Results: 922 pts were classified according to the type of tumor. The most prevalent was lung-pleural cancer (LC) 27%, followed by colorectal cancer (CRC) 17.7%. 25.3% died in an acute care unit of the HJRJ, 48.7% in the hospice care unit (HCU) of the HVD and 26% at home with follow-up by HCU. 70.3% received OT in the last month of life. 11% started a new treatment and 17% received it in the last 14 days of life. 75.8% of the pts were included in the HCU before death. Of these, 4.3% were included in the 72 hours before death. 18.5% of pts went to the Emergency Service more than once in the last month of life. We also analyzed the previous data according to the type of tumor (Table). Conclusions: Our study reflects an overuse of oncology therapies near death. This produces a greater use of resources, such as assistance to the Emergency Service or aggressive actions to alleviate the adverse effects secondary to the treatments. There is a greater TA in pts with head and neck cancer (HNC). These pts usually initially show malnutrition, comorbidities (heart disease, liver disease) and a borderline performance status before starting the treatment. Our data show that the rise of new therapeutic options in LC and breast cancer generated an overuse of treatment near the end-of-life.[Table: see text]