Examining Palliative Care Utilization Among Hospitalized Patients with Diffuse Large B-Cell Lymphoma

Noting a lack of data on palliative care in patients with diffuse large b-cell lymphoma (DLBCL), researchers, led by Inimfon Jackson, MD, MPH, PhD, from the Einstein Medical Center in Philadelphia, examined the prevalence and predictors of palliative care utilization in patients with DLBCL. Their report, published in the Journal of Palliative Care, found that the prevalence of palliative care utilization was low and identified several factors that predicted utilization in hospitalized patients.

The investigators assessed 41,789 patient hospitalizations from the National Inpatient Sample (NIS) cohort. Multivariable logistic regression models were used to indicate predictors of palliative care among hospitalized patients with DLBCL, while descriptive analyses were used to determine the overall prevalence of palliative care utilization across the population.

Approximately 7% of patients received palliative care during hospitalization, among which 4.8% were further discharged alive. Patients with DLBCL aged 70 or older had 1.3 times higher odds of utilizing palliative care compared to patients less than 70 years (95% confidence interval [CI], 1.14–1.41). Patients on insurance types other than Medicare/Medicaid had a 1.7 times greater chance to receive palliative care versus those on it (95% CI, 1.34–2.05). Predictors for receiving palliative care were patients who were transferred to a facility or discharged with home health (adjusted odds ratio [AOR] = 6.23; 95% CI, 5.21–7.44) and those who died during hospitalization (AOR = 45.17; 95% CI, 36.98–55.17). Other associated variables included type of hospital admission, length of stay, receipt of chemotherapy, and number of comorbidities.

The article noted that previous studies have demonstrated that palliative care improves the quality of life of patients with DLBCL, therefore the low utilization observed in this study represents a problem. According to Dr. Jackson, “Our findings highlight the need to increase awareness among medical oncologists on the need to involve the palliative care team early in the management of hospitalized patients with DLBCL.”