Abstract Details

Title Patterns of Death and Palliative Care in Glioma Patients

Topic Neuro-oncology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-010

Objective To describe causes and setting of death from gliomas.

Background Patients with gliomas often inquire about experiencing discomfort at end of life. Understanding common clinical outcomes of tumor progression and circumstances surrounding death may reduce anxiety among patients and caregivers and inform end-of-life planning.

Design/Methods Following IRB approval, we retrospectively analyzed circumstances surrounding death among patients with gliomas at Columbia University Irving Medical Center from 1/2014-10/2018, including immediate cause and location of death (home vs. other) and implementation of palliative measures. Information unavailable from the medical record was supplemented by caregivers prospectively.

Results Data were available for 134 patients (88 men, 46 women; median age at death 62 years, range 24-87). Histology was glioblastoma in 127 (95%). Failure to thrive with transition to supportive care (n=103, 77%) was the most common immediate cause of death. Others included infection (18, 13%; with pulmonary (12, 9%), CNS (3, 2%), urinary tract (2,1%), GI (2,1%), and unknown (1, 1%) sources); intracerebral hemorrhage (4, 3%); seizures (4, 3%); cerebral edema (3, 2%); pulmonary embolism (2, 1%); autonomic failure (2, 1%); and/or hemorrhagic shock (1, 1%). Seven patients had multiple concurrent fatal diagnoses. Sixty-seven patients (50%) died at home with home hospice services. Other locations were inpatient hospice (32, 24%); acute care hospital (32, 24%) including 26 (19%) with and 6 (4%) without palliative measures; skilled nursing facility (2, 1%) including 1 (1%) each with and without palliative measures; or religious facility (1, 1%) with palliative measures. Acute cardiac and/or pulmonary resuscitation was performed in 17 patients (13%), of whom 11 were subsequently transitioned to comfort measures.

Conclusions Failure to thrive with transition to supportive care was the most common (77%) immediate cause of death from glioma followed by infection (13%). Hospice and/or palliative measures were ultimately implemented in 95% of patients, though resuscitative efforts were performed in 13%.

Authors/Disclosures
Marissa A. Barbaro, MD (New York Presbyterian Hospital, Columbia) PRESENTER	Dr. Barbaro has nothing to disclose.
	No disclosure on file
Fabio M. Iwamoto, MD	No disclosure on file
Teri Kreisl (Neuro-oncology Branch, National Cancer)	No disclosure on file
Mary Welch, MD (Columbia University Medical Center)	Dr. Welch has nothing to disclose.
Yazmin Odia, MD, MS, MBA, FAAN (Miami Cancer Institute, BHSF)	Dr. Odia has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PharPoint. Dr. Odia has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for GammaTile. Dr. Odia has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chimeric, part of Jazz Pharmaceuticals.
	No disclosure on file
Andrew B. Lassman, MD, FAAN (Columbia University Irving Medical Center)	No disclosure on file

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