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Table 2 Factors associated with High Intensive End-of-Life (HI-EOL) and Most Invasive End-of-Life (MI-EOL) care (Multivariate Analyses)

From: Intensive end-of-life care in acute leukemia from a French national hospital database study (2017–2018)

 

HI-EOL

MI-EOL

N = 2316 (63,31%)

N = 471 (12,88%)

N (%)

AOR (Cl 95%)

p-value

N (%)

AOR (Cl 95%)

p-value

Age at death (years)

  < 60 (ref)

315 (75.5)

–

 

94 (22.5)

–

 

  [60;70]

459 (73.7)

0.968 (0.708–1.325)

0.841

124 (19.9)

0.959 (0.686–1.341)

0.807

  [70;80]

734 (63.8)

0.688 (0.512–0.926

0.014

128 (11.13)

0.558 (0.394–0.791)

0.001

  > =80

808 (55.0)

0.536 (0.400–0.720)

< 10−3

125 (8.51)

0.445 (0.311–0.635)

< 10− 3

Sex

 Man (ref)

1324 (65.0)

–

 

278 (13.7)

–

 

 Woman

992 (62.1)

0.891 (0.770–1.033)

0.125

193 (11.9)

0.940 (0.761–1.161)

0.567

Year of Death

 2017 (ref)

1126 (62.1)

–

 

220 (12.1)

–

 

 2018

1190 (64.5)

1.072 (0.928–1.239)

0.346

251 (13.6)

1.104 (0.899–1.356)

0.344

Social area living

 Socially advantaged (ref)

1028 (63.9)

–

 

204 (12.7)

  

 Socially disadvantaged

1245 (62.2)

0.944 (0.811–1.100)

0.464

261 (13.0)

1.077 (0.866–1.340)

0.506

Type of leukemia

 Acute myeloid leukemia (ref)

2154 (62.8)

–

 

426 (12.4)

–

 

 Acute lymphoid leukemia

162 (69.8)

1.063 (0.773–1.460)

0.708

45 (19.4)

1.216 (0.840–1.760)

0.300

Allo-SCT

 No (ref)

2109 (62.1)

–

 

400 (11.8)

–

 

 Yes

207 (78.4)

1.186 (0.832–1.692

0.345

71 (26.9)

1.335 (0.934–1.906)

0.113

Charlson score (co-morbidities) a

 0 (ref)

870 (59.66)

–

 

149 (10.2)

–

 

 1–2

939 (66.6)

1.300 (1.104–1.532)

< 10−3

190 (13.5)

1.317 (1.033–1.679)

0.003

  ≥ 3

507 (64.3)

1.142 (0.939–1.89)

0.184

132 (16.8)

1.720 (1.312–2.253)

< 10−3

Type of hospital b

 Non-specialized hospital (ref)

1328 (59.2)

–

 

217 (9.7)

  

 Specialized hospital

988 (69.9)

1.357 (1.157–1.592)

< 10−3

254 (18.0)

1.634 (1.312–2.034)

< 10− 3

Time in a palliative care structure

  ≤ 1 month (ref)

1611 (63.3)

  

336 (13.2)

  

  > 1 month

705 (63.3)

0.577 (0.481–0.690)

< 10−3

135 (12.1)

0.659 (0.509–0.853)

0.002

Time from patients’ home (minutes)

  ≤ 10 (ref)

617 (58.9)

  

108 (10.3)

  

  [10–30]

684 (63.9)

1.224 (1.017–1.474)

0.032

131 (12.2)

1.164 (0.79–1.542)

0.289

 [30–60]

404 (62.0)

1.114 (0.897–1.382)

0.330

81 (12.4)

1.161 (0.840–1.604)

0.366

  > 60

537 (67.5)

1.205 (0.977–1.486)

0.081

138 (17.3)

1.335 (0.934–1.906)

0.113

Length of stay (days)

  < 7 (ref)

250 (47.1)

–

 

46 (10.4)

–

 

  [7–15]

514 (60.3)

2.114 (1.650–2.709)

< 10−3

81 (10.0)

0.910 (0.608–1.361)

0.645

  [15–30]

936 (68.8)

4.053 (3.212–5.114)

< 10− 3

197 (13.2)

1.159 (0.807–1.663)

0.425

  > 30

704 (76.9)

7.104 (5.389–9.365)

< 10−3

147 (16.1)

1.474 (0.994–2.186)

0.054

  1. HI-EOL: High Intensive End-of-Life (at least one of the following indicators: 1. at least one intensive care unit (ICU) admission in the last 30 days of life; 2. more than one emergency department admission in the last 30 days of life; 3. more than one acute care hospitalization in the last 30 days of life; or 4. at least one intravenous chemotherapy treatment in the last 14 days of life)
  2. MI-EOL: Most Invasive End-of-Life (at least one of the following indicators in the last 30 days of life: 1. orotracheal intubation; 2. mechanical ventilation; 3. artificial feeding (enteral or parenteral); 4. cardiopulmonary resuscitation; 5. gastrostomy; or 6. hemodialysis)
  3. Allo-SCT: Allogeneic stem cell transplantation
  4. AOR (95% CI): adjusted odd ratio (95% confidence interval)
  5. a Charlson modified score (excluding malignancies/metastasis)
  6. b Specialized centers include cancer units of an university hospital and units of a cancer hospital, non-specialized centers include all the other cases
  7. ref: reference modality for the AOR
  8. Bold values: p-value< 0.05
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