Mapping the patterns of care, the receipt of palliative care and the site of death for patients with malignant glioma

Abstract High-grade malignant glioma patients face apoor prognosis, preceded by rapid functional and neuro-behavioural changes, making multidisciplinary care incor-porating supportive and palliative care important. Thisstudy aimed to quantify the association between symptoms,receipt of supportive and palliative care and site of death.We undertook a retrospective cohort study between 2003and 2009 of incident malignant glioma cases who survivedfor at least 120 days between their first hospitalisation andtheir death (n = 678) in Victoria, Australia, using linkedhospital, emergency department and death data. Themedian age of patients was 62 years, 40 % were female,and the median survival was 11 months. Twenty-six per-cent of patients died outside of hospital, 49 % in a pallia-tive care bed/hospice setting and 25 % in an acute hospitalbed. Patients having 1 or more symptoms were more thanfive times as likely to receive palliative care. Patients whoreceive palliative care are 1.7 times more likely to dieoutside of hospital. In conclusion malignant gliomapatients with a high burden of symptoms are more likely toreceive palliative care and, in turn, patients who receivepalliative care are more likely to die at home.Keywords Malignant glioma Palliative care Symptom burden Population cohort study Coded hospital data Adjusted odds ratio