A large study suggests that children with cancer are more likely to die in a hospital than at home. Data shows that 52% of patients died in the hospital and 40% died at home. These findings were published in JAMA Pediatrics.
To determine where pediatric cancer patients died, researchers analyzed data from the CDC WONDER database, which included 36,889 deaths between 2003 and 2020, including:
52.0% of patients died in a hospital, 39.3% died at home, 6.1% died in an outpatient or emergency department facility, 2.2% died in a hospice setting, and 0.5% died in a nursing home.
Patients were more likely to die in the hospital if they were Asian (odds ratio (OR), 1.79; 95% CI, 1.62-1.97; P <.001), black (OR, 1.60; 95% CI, 1.51-1.70; P <.001), or Hispanic (OR, 1.88; 95% CI, 1.78-1.97; P <.001) than non-Hispanic white.
Patients were less likely to die at home if they were American Indian (OR, 0.64; 95% CI, 0.52-0.79; P <.001), Asian (OR, 0.52; 95% CI, 0.47-0.58; P <.001), or black (OR, 0.49; 95% CI, 0.46-0.52; P <.001) than white.
Patients were more likely to die in hospice if they were 5 to 9 years of age (OR, 1.45; 95% CI, 1.12 to 1.88; P =.005) or 10 to 19 years of age (OR, 2.18; 95% CI, 1.74 to 2.73; P <.001) than if they were 1 to 4 years of age.
Patients were more likely to die in an outpatient facility or emergency department if they were American Indian (OR, 2.07; 95% CI, 1.48-2.88; P <.001) or black (OR, 1.89; 95% CI, 1.71-2.10; P <.001) than white.
“In contrast to previous literature on trends among adult cancer patients, pediatric patients in this study had a lower rate of home mortality, likely because pediatric patients received more aggressive EOL care than adult patients,” the researchers wrote.
Moreover, lack of resources may mean that families are unable to meet patients’ needs at home, so “developing the capacity of palliative care teams to reach patients in many end-of-life situations may be worthwhile to support patients and families to end their lives in accordance with their wishes”, they added.
Disclosures: This study was supported by a grant from the National Cancer Institute. One study author disclosed a conflict of interest. See the original references for full disclosures.
This article originally appeared on Cancer Therapy Advisor.
