消化管がんと入院患者の死亡率における緩和ケア相談と終末期ケア
Suriya Baskar1, Udhayvir Singh Grewal2
1Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY.
JCO oncology practice
|September 5, 2025
まとめ
末期の食道がん患者の緩和ケア (PCC) は,介入の減少と病院滞在の短縮と関連していました. しかし,黒人の患者は白人の患者よりPCCの頻度が低い.
科学分野:
- 腫瘍学
- 緩和ケア
- 医療サービス研究
背景:
- 進んだ食道がんは症状の重みがあり,生存率は低い.
- 進んだ食道癌の患者は 高い入院率を経験し,生活の質に影響します.
- 終末期ケア (EoL) と緩和ケア (PCC) の相談は,この集団にとって極めて重要です.
研究 の 目的:
- 進んだ食道がん患者のEoL入院に対するPCCの影響を分析する.
- この患者グループ内のEOLケアにおける人種差を評価する.
- PCCと医療介入,滞在期間,病院料金との関連性を評価する.
主な方法:
- 2016年から2020年にかけての国立入院患者サンプル (NIS) データベースを利用した.
- 食道癌で入院した患者が 病院で亡くなりました
- 特定されたEoLアウトカム:PCC,DNR状態,および医療介入 (換気,輸血,血管圧縮剤,化学療法).
主要な成果:
- 17,745人の入院のうち,58. 4%がPCCを受けた.
- PCCは,より短いLOS,より低い病院料金,より高いDNR率と関連していました.
- 黒人患者 (aOR0. 53) のPCCは白人患者と比較して低いDNR率 (aOR0. 81) であった.
結論:
- EoLでの緩和医療の診察は DNR ステータスの増加と医療介入の減少と相関しています.
- 先進的な食道がん患者の間でPCCの利用とDNRの状態に人種差異がある.
- マイノリティの人々に対するEOLのケアにおける不平等に対処するためにさらなる研究が必要である.
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