Mortality pattern of cancer patients followed in Palliative Care: a retrospective analysis

The aim of this study was to identify the places of death of patients with solid cancer under follow-up by a Palliative Care team and to recognize factors that influence the place of death.

Retrospective study of cancer patients whose deaths occurred between January 1, 2022, and January 1, 2024, followed up by a Palliative Care team in a Portuguese public hospital. Demographic and clinical data were reviewed through clinical file consultation and were analyzed by Statistical Package for the Social Sciences® v.29, considering a p<0.05 as statistically significant.

The sample included 413 cancer patients; 60.5% were male, and 72.9% were Eastern Cooperative Oncology Group 3-4. The median age was 75 years, and the median follow-up duration in Palliative Care was 40 days. Death in a hospital setting occurred in 64.4% of the patients. The most common types of cancer were gastrointestinal/hepato-bilio-pancreatic (41.6%) and lung cancers (18.6%). Death due to cancer progression was the main cause of death (88.4%). In a multivariate logistic regression, factors associated with higher odds of hospital death were age <75 years (OR 1.88, 95%CI 1.22-2.90) and follow-up duration in Palliative Care <30 days (OR 2.59, 95%CI 1.66-4.04). Death due to cancer progression was associated with lower odds of hospital death (OR 0.03, 95%CI 0.004-0.21).

Death in a hospital setting was predominant in this sample, which is in line with outcomes from international studies. These findings highlight the need for early palliative care referral and advance care planning to support patients' preferences for place of death.