Male-female patient differences in the association between end-of-life discussions and receipt of intensive care near death. Academic Article Article uri icon

Overview

MeSH

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Humans
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Sex Characteristics

MeSH Major

  • Critical Care
  • Terminal Care

abstract

  • Patient gender plays a significant role in patient-physician communication, patients' understanding of illness, and the aggressiveness of end-of-life (EoL) care. However, little is known about the extent to which gender differences in the effects of EoL discussions on EoL care contribute to gender differences in EoL care. The current study was aimed at determining whether gender differences exist in the receipt of intensive care unit (ICU) care near death and in the association between EoL discussions and the receipt of EoL ICU care. This was a multisite, prospective cohort study of patients (n = 353) with metastatic cancers who were identified as terminally ill at study enrollment and were interviewed at a median of 4.1 months before their deaths. Postmortem chart reviews and caregiver interviews documented ICU stays in the last week of life. Patients who received ICU care at the EoL were more likely to be male than those who did not (73% vs 52%, P = .02). After adjustments for potential confounders, male patients reporting an EoL discussion were less likely to have an ICU stay in the last week of life than male patients with no EoL discussion (adjusted odds ratio, 0.26, 95% confidence interval, 0.07-0.91; P = .04). There was no association between EoL discussions and ICU stays near death among female patients. Men with advanced cancers are more likely than women to receive aggressive, nonbeneficial ICU care near death. Gender differences in the effects of EoL discussions on EoL care likely contribute to and may even explain gender differences in the receipt of ICU care in the last week of life. © 2015 American Cancer Society.

publication date

  • August 15, 2015

has subject area

  • Adult
  • Aged
  • Cohort Studies
  • Critical Care
  • Female
  • Humans
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Sex Characteristics
  • Terminal Care

Research

keywords

  • Journal Article
  • Multicenter Study

Identity

Language

  • eng

PubMed Central ID

  • PMC4529758

Digital Object Identifier (DOI)

  • 10.1002/cncr.29417

PubMed ID

  • 25975179

Additional Document Info

start page

  • 2814

end page

  • 2820

volume

  • 121

number

  • 16