Factors Associated with aggressiveness End of Life care for Lung cancer patients and associated costs of care

Abstract Purpose Results of previous studies demonstrated that high-intensity end-of-life (EOL) care improves neither cancer patients’ survival nor quality-of-life. The objective was to assess incidence, and factors associated with aggressiveness of care during the last 30 days of life (DOL) of lung cancer (LC) patients and the impacts of aggressiveness of care in EOL-care costs. Patients and Methods Using French national hospital database, all patients with LC who died between 01/01/2010-31/12/2011, or 01/01/2015-31/01/2016 were included. EOL-care aggressiveness was assessed using the following criteria: 1) chemotherapy administered within last 14 DOL; 2) >1 hospitalization within last 30 DOL; 3) intensive care unit (ICU) admission within last 30 DOL; and 4) palliative care initiated Results Among 79,746 adult LC patients identified, 57% had at least one indicator of EOL-care aggressiveness (49% repeated hospitalizations, 12% ICU admissions, 9% chemotherapy, 5% palliative care). It increased significantly between the 2 periods (56% vs 58%, P Conclusion In France, a majority of LC patients had at least 1 criterion of aggressive EOL care, that had major economic impact on the healthcare system.