P08.11.A PREDICTIVE SOCIAL FACTORS ASSOCIATED TO PLACE OF DEATH IN MALIGNANT GLIOMAS

Abstract

Abstract BACKGROUND Malignant gliomas (MG) are tumors affecting central nervous system (CNS) with a poor prognosis. Fast neurological decline (motor, cognitive and behavioural) causes high burden for patients and caregivers and requires specific setting of care (especially palliative care) helping patients to preserve their autonomy and assuring, in the end of life phase, the best care represented by dying at home with dignity that is considered in the literature an indicator of good quality of care in cancer patients. MATERIAL AND METHODS The home care program for MG utilized in our Institution is aimed to offer palliative and supportive care during all the trajectory of disease and to facilitate death at home. To identify possible factors related with place of death, we’ve retrospectively investigated social and health data to discover possible factors associated with dying at home in MG patients. Every patient and caregiver/family were analyzed for many factors including sex, work, family relation, presence or absence of caregiver/family, presence of children. RESULTS From January 2016 to December 2020, we’ve assisted at home 263 MG patients and collected complete data in 257 patients (6 patients was lost in follow-up). 174 (68%) of them were affected by Glioblastoma Multiforme (GBM) and 83 (32%) were affected by grade 3 anaplastic gliomas; 155 patients (61%) were male and 102 (39%) female. 137 patients (54%) died at home, 88 patients (34%) died in hospice and 32 patients (12%) died in hospital. Male caregivers assisted 178 MG patients of which 141 was male patients (79%); female caregivers assisted 79 MG patients of which 65 was female patients (82%) (p<0.001); presence of social network (family or other type) influenced positively place of death: MG patients who has social network died frequently at home respect on MG patients who didn’t have social network that died frequently in hospital or hospice (p<0.001). No differences were found between age, sex (patient and caregiver), presence of minor children, education level, work, marital status and place of death. CONCLUSION In this cohort of MG patients followed with a palliative home care service, place of death and dying with dignity is influenced by presence of social network and reliable caregiver. The evaluation social data in addition to clinical data is an important factor in order to plan timely the end of life phase and the decisions about possible place of death.