Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer.

Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer. Research Abstract Details 

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Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer. Abstract Text:

Gulshan Sharma,Jean Freeman,Dong Zhang,James S Goodwin,Gulshan Sharma,Jean Freeman,Dong Zhang,James S Goodwin,

BACKGROUND: There is increasing concern about the appropriateness of intensive medical care near the end of life in ICUs throughout the United States. As a result of hospice expansion in the 1990s, we hypothesized that ICU use decreased over time in older adults with advanced lung cancer. METHODS: Retrospective analysis using the linked Surveillance, Epidemiology and End Results Medicare database. There were 45,627 Medicare beneficiaries >/= 66 years of age with confirmed stage IIIB or IV lung cancer between January 1, 1992, and December 31, 2002, who died within a year of their cancer diagnosis from 1993 through 2002. RESULTS: ICU use in the last 6 months of life increased from 17.5% in 1993 to 24.7% in 2002 (p < 0.001). After adjusting for patient characteristics, there was a 6.6% annual increase in ICU use from 1993 to 2002. During the same period, hospice use had risen from 28.8 to 49.9% (p < 0.001). A total of 6.2% of patients received both end-of-life ICU care and hospice care, a percentage that increased over time. The total health-care cost for Medicare fee-for-service patients during last 6 months was $40,929 for ICU users and $27,160 for non-ICU users (p < 0.001). CONCLUSION: Despite increasing hospice use, ICU utilization among older adults dying with advanced lung cancer continued to rise in the United States during the 1990s.

Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer. Publishing Authors By Initials

G Sharma,J Freeman,D Zhang,JS Goodwin,G Sharma,J Freeman,D Zhang,JS Goodwin,

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Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Chest

VOLUME: 133

Page Numbers: 72-8

Journal Abbreviation: Chest

ISSN: 0012-3692

DAY: 7

MONTH: 11

YEAR: 2007

Trends in End-of-Life ICU Use Among Older Adults With Advanced Lung Cancer. Information

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LANGUAGE: eng

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AFFILIATION: Allergy Pulmonary Immunology Critical Care and Sleep (APICS) Division, 301 University Blvd, JSA-5.112, UTMB, Galveston, TX 77555-0561. gulshan.sharma@utmb.edu.

Country: United States

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