Inpatient palliative care utilisation among patients with gallbladder cancer in the United States: A 10‐year perspective

• Published in: European journal of cancer care Vol. 31; no. 6; pp. e13520 - n/a
• Main Authors: Mojtahedi, Zahra, Shan, Guogen, Ghodsi, Katayoon, Callahan, Karen, Yoo, Ji W., Vanderlaan, Jennifer, Reeves, Jerry, Shen, Jay J.
• Format: Journal Article
• Language: English
• Published: Oxford Hindawi Limited 01-11-2022
• Subjects: Cancer; Comorbidity; Demographics; Demography; Gallbladder; Gallbladder cancer; hospital charges; Length of stay; Obesity; Palliation; Palliative care; Patients; race; Regression analysis; United States > US
• ISSN: 0961-5423; 1365-2354
• DOI: 10.1111/ecc.13520

Objectives
Gallbladder cancer (GBC) is a rare, poor‐prognosis cancer with unique demographics, comorbidities and a paucity of research. This study investigated inpatient palliative care and its associations with demographics, comorbidities (e.g., obesity), length of stay and hospital charges in GBC in US hospitals (2007–2016).
Methods
Data were extracted from the National Inpatient Sample (NIS) database that contains deidentified clinical and nonclinical information for each hospitalisation. Inpatient palliative care utilisation was identified using the International Classification of Diseases (ICD‐9 and ICD‐10) codes (V66.7 and Z51.5). Generalised regression analysis was conducted with adjustment for variations in predictors.
Results
Of the 4921 reported GBC hospitalizations, only 10.3% encountered palliative care. Palliative care was associated with reduced hospital charges by $12,405 per hospitalisation (P < 0.0001) with no change in length of stay. Palliative care utilisation increased over time (P = 0.004). It was associated with age >80 years, with more severe disease, and in‐hospital death (P < 0.0001). Obesity had a negative association with palliative care utilisation (P = 0.0029).
Discussion
Our novel study found that obese people were less likely to use palliative care services in GBC. Interventions are needed to increase palliative care consultation in GBC patients, particularly in obese patients.