ArticleCancer2020
Potentially burdensome end-of-life transitions among nursing home residents with poor-prognosis cancer.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Racial/Ethnic Disparities in Nursing Home End-of-Life Care: A Systematic Review.Journal of the American Medical Directors Association · 2021Pooled it
- Factors associated with dying in hospital awaiting palliative care admission: a retrospective cohort study.BMC palliative care · 2026Article
- Geographic variations in end-of-life hospitalisations for patients with mental illness: a population-based observational study in England, UK.Discover mental health · 2025Article
- Use of Nursing Homes Among Medicaid Beneficiaries Newly Diagnosed With Cancer.Journal of the American Geriatrics Society · 2025Article
- Respect for the Patient-Oncologist Relationship May Limit Serious Illness Communication by Acute and Postacute Care Clinicians After Discharge to a Skilled Nursing Facility.JCO oncology practice · 2025Article
- Understanding the Utility of Less Than Six-Month Prognosis Using Administrative Data Among U.S. Nursing Home Residents With Cancer.Palliative medicine reports · 2024Article
- Exploring the Holistic Needs of People Living with Cancer in Care Homes: An Integrative Review.Healthcare (Basel, Switzerland) · 2023Review
- End-of-Life Care Transitions in Assisted Living: Associations With State Staffing and Training Regulations.Journal of the American Medical Directors Association · 2023Article
- The epidemiology of preexisting geriatric and palliative conditions in older adults with poor prognosis cancers.Journal of the American Geriatrics Society · 2022Article
- Fragmentation of care in the last year of life: Does dementia status matter?Journal of the American Geriatrics Society · 2022Article
- Integrating Functional Assessment Into Clinical Decision-Making for Older Adults Across the Cancer Care Continuum.JCO oncology practice · 2022Article
- Cancer patients spend more time at home and more often die at home with advance care planning conversations in primary health care: a retrospective observational cohort study.BMC palliative care · 2022Observational
- Evaluation of Family Characteristics and Multiple Hospitalizations at the End of Life: Evidence from the Utah Population Database.Journal of palliative medicine · 2022Article
- Cultural and Ethical Barriers to Cancer Treatment in Nursing Homes and Educational Strategies: A Scoping Review.Cancers · 2021Article
- Comparative effectiveness of denosumab, teriparatide, and zoledronic acid among frail older adults: a retrospective cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021Article
- Association of Timely Goals of Care Discussions with Hospitalizations Due to Infections in Nursing Homes.Palliative medicine reportsArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundThis study examined factors associated with potentially burdensome end-of-life (EOL) transitions between care settings among older adults with advanced cancer in nursing homes (NHs).
methodsA retrospective analysis of deceased older NH residents with poor-prognosis solid tumors was conducted with Medicare claims and the Minimum Data Set. A potentially burdensome transition was defined as 2 or more hospitalizations or an intensive care unit admission in the last 90 days of life.
resultsAmong 34,670 subjects, many had moderate to severe cognitive impairment (53.8%), full dependence in activities of daily living (ADLs; 66.5%), and comorbidities such as congestive heart failure (CHF; 29.3%) and chronic obstructive pulmonary disease (34.1%). Only 56.3% of the patients used hospice at any time in the 90 days before death; 36.0% of the patients experienced a potentially burdensome EOL transition, and this was higher among patients who did not receive hospice (45.4% vs 28.7%; P < .01). In multivariable analyses, full dependence in ADLs (odds ratio [OR], 1.70; P < .01), CHF (OR, 1.48; P < .01), and chronic obstructive pulmonary disease (OR, 1.28; P < .01) were associated with a higher risk of burdensome EOL transitions. Those with do-not-resuscitate directives (OR, 0.60; P < .01) and impaired cognition (OR, 0.89; P < .01) had lower odds of burdensome EOL transitions.
conclusionsNH residents with advanced cancer have substantial comorbidities and functional impairment, yet more than a third experience potentially burdensome EOL transitions. These findings help to identify a population at risk for poor EOL outcomes in order to target interventions, and they point to the importance of advanced care planning in this population.
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