Factors Associated with Antimicrobial Use at the End-Of-Life Among Hospitalized Cancer Patients.
Am J Hosp Palliat Care
; 41(1): 8-15, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-36812451
ABSTRACT
Background:
Antimicrobials are frequently administered at end-of-life (EOL) and their non-beneficial use may subject patients to unnecessary harms. Studies analyzing factors for antimicrobial prescribing in solid tumor cancer patients at the EOL are lacking. Thus, we aimed to identify factors and patterns associated with antimicrobial use in hospitalized adults with cancer at EOL.Methods:
We used a retrospective cohort design to review electronic medical records of terminal hospitalized patients ≥18 years with solid tumors admitted to non-intensive care units in a metropolitan comprehensive cancer center during 2019 and assessed antimicrobial use in the last 7 days of life.Results:
Among 633 cancer patients, 59% (n = 376) received antimicrobials (AM+) within the last 7 days of life. AM + patients were older (P = .012), mostly of male gender (55%), and non-Hispanic ethnicity (87%). AM + patients were significantly more likely to have a foreign device, suspected signs of infection, neutropenia, positive blood culture result, documented advance directive; receive laboratory or radiologic testing, and a palliative care or infectious disease consultation (all P < .05). No statistically significant differences were observed in the presence of documented goals of care discussions, or EOL discussions/EOL care orders.Conclusion:
Antimicrobial use at the EOL is common in solid tumor cancer patients at the EOL and is associated with increased utilization of invasive interventions. There is an opportunity for infectious disease specialists to build primary palliative care skills and partner with antimicrobial stewardship programs to better advise patients, decision makers, and primary teams on the use of antimicrobials at the EOL.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Assistência Terminal
/
Doenças Transmissíveis
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Anti-Infecciosos
/
Neoplasias
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
Am J Hosp Palliat Care
Assunto da revista:
ENFERMAGEM
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos