Utility of 30-day mortality as a quality metric for palliative radiation treatment: A population-based analysis from Queensland, Australia

被引:0
|
作者
Guan, Tracey L. [1 ,12 ]
Kutzko, Justin H. [2 ,3 ,4 ]
Lunn, Dominic P. [2 ,5 ,6 ]
Dunn, Nathan A. M. [1 ]
Burmeister, Bryan H. [2 ,7 ,8 ]
Dadwal, Parvati [9 ,10 ]
Tran, Nancy [1 ]
Holt, Tanya R. [2 ,4 ,6 ,11 ]
机构
[1] Canc Alliance Queensland, Brisbane, Qld, Australia
[2] Radiat Oncol Sub Comm, Queensland Canc Control Safety & Qual Partnership, Brisbane, Qld, Australia
[3] William Osler Hlth Syst, Brampton, ON, Canada
[4] Univ Queensland, Brisbane, Qld, Australia
[5] Gold Coast Univ Hosp, ICON, Brisbane, Qld, Australia
[6] Greenslopes Hosp, ICON, Brisbane, Qld, Australia
[7] St Stephens Hosp Oncol, GenesisCare, Hervey Bay, Qld, Australia
[8] Univ Queensland, Rural Clin Sch, Hervey Bay, Qld, Australia
[9] Cairns Hosp, Cairns, Qld, Australia
[10] James Cook Univ, Townsville, Qld, Australia
[11] Princess Alexandra Hosp ROPART, Brisbane, Qld, Australia
[12] Princess Alexandra Hosp, Canc Alliance Queensland, Metro South Hlth, 2 Burke St, Woolloongabba, Qld 4102, Australia
关键词
30 day mortality; end of life; fractionation schedule; palliative radiotherapy; LAST; 30; DAYS; LIFE EXPECTANCY; CANCER-PATIENTS; LUNG-CANCER; CARE; END; RADIOTHERAPY; AGGRESSIVENESS; MANAGEMENT; THERAPY;
D O I
10.1111/1754-9485.13633
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
IntroductionPalliative radiotherapy (PRT) is frequently used to treat symptoms of advanced cancer, however benefits are questionable when life expectancy is limited. The 30-day mortality rate after PRT is a potential quality indicator, and results from a recent meta-analysis suggest a benchmark of 16% as an upper limit. In this population-based study from Queensland, Australia, we examined 30-day mortality rates following PRT and factors associated with decreased life expectancy.MethodsRetrospective population data from Queensland Oncology Repository was used. Study population data included 22,501 patients diagnosed with an invasive cancer who died from any cause between 2008 and 2017 and had received PRT. Thirty-day mortality rates were determined from the date of last PRT fraction to date of death. Cox proportional hazards models were used to identify factors independently associated with risk of death within 30 days of PRT.ResultsOverall 30-day mortality after PRT was 22.2% with decreasing trend in more recent years (P = 0.001). Male (HR = 1.20, 95% CI = 1.13-1.27); receiving 5 or less radiotherapy fractions (HR = 2.97, 95% CI = 2.74-3.22 and HR = 2.17, 95% CI = 2.03-2.32, respectively) and receiving PRT in a private compared to public facility (HR = 1.61, 95% CI = 1.51-1.71) was associated with decreased survival.ConclusionThe 30-day mortality rate in Queensland following PRT is higher than expected and there is scope to reduce unnecessarily protracted treatment schedules. We encourage other Australian and New Zealand centres to examine and report their own 30-day mortality rate following PRT and would support collaboration for 30-day mortality to become a national and international quality metric for radiation oncology centres.
引用
收藏
页码:316 / 324
页数:9
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