Abstract: Contemporary Review of End-of-Life Outcomes and Care in Patients with High-Grade Glioma
Objective: To evaluate the accessibility of palliative care services and their impact on end-of-life outcomes among patients with high-grade glioma (HGG) in Victoria, Australia.
Methods: A retrospective cohort analysis was conducted using data from the Victorian Cancer Registry. All patients diagnosed with high-grade glioma (glioblastoma, grade 3 and 4 astrocytoma, and grade 3 anaplastic oligodendroglioma) who died between January 2018 and January 2023 were included. Demographic characteristics, timing of referral to palliative care services, and utilization of hospital and palliative care resources prior to death were examined.
Results: Among the 1,472 patients with HGG who died during the study period, timely referrals to palliative care services occurred in 38.0% of cases, while 40.0% received late referrals and 22.0% had no referral. Patients with timely referrals were significantly more likely to die outside of hospital settings (44.2%) and specifically within dedicated palliative care beds (37.4%). Conversely, patients referred late to palliative care services were more frequently hospitalized at the time of death, with only 19.7% dying outside hospital settings and 60.6% within dedicated palliative care beds.
Conclusions: Early referral to palliative care services significantly influences end-of-life outcomes for patients with high-grade glioma, notably increasing the likelihood of death occurring outside of hospital environments. Enhancing timely access to palliative care is crucial for improving quality-of-life outcomes in this patient population.