Condicionantes del lugar de defunción de pacientes con enfermedad oncológica terminal, adscritos al ESAD, en la provincia de Huesca

Objectives: the purpose of this study was to assess the conditions that influence the death of oncological patients in their homes. Method: we carried out a retrospective study of patients recruited in a palliative care program in Huesca province who died in 2006. We selected oncological patients older than 18 years, with a main carer, and more than tree days in the program. After reviewing the literature, we selected several factors that were highly related to place of death. We designed a questionnaire including thirteen of these factors: "place of death", "age", "sex", "Pfeiffer", "Barthel", "type of cancer", "social class", "place of residence", "main carer", "number of homecare visits", "number of days as inpatient", and "number of days in program". Statistical analyses for categorical and non-categorical variables were made with the SPSS 14 program. Results: 108 patients were selected: 61% of them were men and 39% women; 57.4% died at home and 42.6% died in an acute hospital; 75% lived in urban areas and 25% in rural areas, with a median of 74.6 days in the palliative care program. Median age was 78 years. The condition was a solid tumour in 91.7% of cases, while the remaining 8.3% had other types of tumour. Social status was grouped into eight categories. Median of days in the program was 41.5, and median disease duration was 235 days. No relations were found between: functional status, mental status, sex, social class, main carer, days in program, intensity of home care, and long disease duration or tumour type. Variables associated with death at home were: living in a rural area (p = 0.013), and extended family support (p = 0.009). The relation between death at home and age is questionable (p = 0.049) Conclusions: Death at home is more frequent in patients living in rural areas, and having more than one caregiver.