Abstract Details

Title Place of Death Surrounding Motor Neuron Disease Mortality in the United States Before and During the COVID-19 Pandemic, 2018-2021

Topic Palliative Care

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 6-007

Objective To examine whether COVID-19 pandemic altered place of death of MND patients.

Background To date, little information is available on place of death for motor neuron disease (MND) patients in the United States (U.S.) during the COVID-19 pandemic.

Design/Methods A population-based cross-sectional analysis was conducted of all U.S. adult MND deaths from two periods: 2018 –2019 (pre-COVID), and 2020–2021 (during COVID years). We used chi-square tests to examine the association between MND place of death and COVID-19 time periods (pre vs. during). Using multivariate logistic regression, we modeled the association between place of death with demographic characteristics.

Results The average number of MND deaths statistically increased 6.5% from 15,041 pre-COVID to 16,018 during the COVID years (p<0.0001). Death in decedent's home increased significantly (20.1%, p<0.0001) at 9,117 during COVID years (from 7,593 pre-COVID), and the combined death in nursing homes/hospice facilities decreased 19.3% (from3,552 pre-COVID to 2,977 COVID years). Among the Hispanic population, there was a statistically significant increased likelihood of dying at home compared to a nursing home/hospice facility during the COVID years (OR=1.57, 95%CI: 1.22-2.02, p=0.0004) against the pre-COVID, non-Hispanic population. The pattern was similar among the White population during COVID years (OR=1.13, 95%CI: 0.94-1.37, p=0.1985), but the likelihood of dying at home was significantly less for the pre-COVID years (OR=0.83, 95%CI: 0.69-0.99, p=0.0358). Among the 10 listed comorbidities, sepsis significantly increased the likelihood of death in nursing homes compared to hospitals or decedent’s home (OR=2.36, 95%CI: 1.37-4.07, p=0.0021). Similarly, diabetes (OR=1.26, 95%CI: 1.03-1.55, p=0.0275) and essential hypertension (OR=1.17, 95%CI: 1.01-1.36, p=0.0345) significantly increased the likelihood of death in decedent’s home compared to nursing home and hospital.

Conclusions

In analyzing national death certificate data to investigate the impact of COVID-19 on place of death environments for MND mortality, the number of deaths occurring in the home increased over 20%.

Authors/Disclosures
Moon Han, PhD (Agency for Toxic Substances and Disease Registry) PRESENTER	Dr. Han has nothing to disclose.
Jaime Raymond	Jaime Raymond has nothing to disclose.
Paul Mehta	Paul Mehta has nothing to disclose.
Theodore Larson	Theodore Larson has nothing to disclose.
D Kevin Horton	No disclosure on file

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