Table 3.
Multivariate Logistic Regression Analysis of Factors Associated With the Worsening of Symptoms During the Period Patients Received Specialist Palliative Care
| Variables |
Pain
|
Shortness of breath
|
Weakness or lack of energy
|
Sore or dry mouth
|
Drowsiness
|
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | |
| Unadjusted model | |||||||||||||||
| Palliative care at home | 0.79 | 0.35–1.80 | 0.541 | 1.42 | 1.08–1.88 | 0.014 | 1.11 | 0.73–1.71 | 0.596 | 1.00 | 0.59–1.69 | 0.986 | 1.23 | 0.86–1.78 | 0.238 |
| Adjusted model | |||||||||||||||
| Palliative care at home | 0.75 | 0.34–1.65 | 0.436 | 1.14 | 0.85–1.52 | 0.375 | 0.93 | 0.63–1.38 | 0.711 | 0.90 | 0.54–1.48 | 0.641 | 1.07 | 0.73–1.58 | 0.706 |
| Demographic and clinical characteristics at registration | |||||||||||||||
| Age ≥65 | 0.82 | 0.49–1.37 | 0.417 | 0.87 | 0.64–1.19 | 0.374 | 0.83 | 0.63–1.10 | 0.188 | 0.95 | 0.72–1.24 | 0.678 | 0.96 | 0.65–1.41 | 0.824 |
| Male sex | 0.93 | 0.63–1.37 | 0.696 | 1.10 | 0.89–1.35 | 0.379 | 0.99 | 0.79–1.25 | 0.951 | 1.14 | 0.92–1.41 | 0.226 | 0.94 | 0.72–1.23 | 0.636 |
| Site of primary cancer: Lung | — | — | — | 1.48 | 1.07–2.05 | 0.020 | — | — | — | — | — | — | — | — | — |
| Site of metastasis: bone | 1.02 | 0.64–1.62 | 0.924 | — | — | — | — | — | — | — | — | — | — | — | — |
| Site of metastasis: lung | — | — | — | 1.41 | 1.15–1.73 | <0.001 | — | — | — | — | — | — | — | — | — |
| Site of metastasis: central nervous system | — | — | — | — | — | — | — | — | — | — | — | — | 1.18 | 0.85–1.65 | 0.323 |
| Anorexia | — | — | — | — | — | — | 0.77 | 0.52–1.15 | 0.190 | — | — | — | — | — | — |
| Weight loss in the previous month | — | — | — | — | — | — | 0.99 | 0.77–1.26 | 0.901 | — | — | — | — | — | — |
| Pleural effusion | — | — | — | 1.30 | 1.01–1.69 | 0.046 | — | — | — | — | — | — | — | — | — |
| Delirium (DSM-5) | — | — | — | — | — | — | — | — | — | — | — | — | 0.90 | 0.65–1.23 | 0.484 |
| Modified PiPS-A: months | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. |
| Modified PiPS-A: weeks | 0.83 | 0.56–1.23 | 0.329 | 0.74 | 0.50–1.09 | 0.120 | 0.72 | 0.56–0.94 | 0.014 | 0.82 | 0.58–1.16 | 0.243 | 0.93 | 0.66–1.32 | 0.683 |
| Modified PiPS-A: days | 0.72 | 0.43–1.19 | 0.188 | 0.47 | 0.27–0.83 | 0.012 | 0.51 | 0.34–0.77 | 0.002 | 0.73 | 0.45–1.18 | 0.184 | 0.66 | 0.44–0.98 | 0.038 |
| Palliative Prognostic Index ≥6.5 | 1.07 | 0.57–2.00 | 0.813 | 0.42 | 0.31–0.56 | <0.001 | 0.81 | 0.60–1.11 | 0.178 | 0.91 | 0.69–1.20 | 0.499 | 0.90 | 0.67–1.23 | 0.512 |
| Age-adjusted Charlson comorbidity index ≥6 | 1.08 | 0.54–2.15 | 0.815 | 1.08 | 0.63–1.84 | 0.778 | 0.93 | 0.55–1.57 | 0.785 | 0.83 | 0.46–1.52 | 0.539 | 1.11 | 0.66–1.85 | 0.692 |
| Opioid dosage (OME ≥60 mg/day) | 0.91 | 0.58–1.43 | 0.662 | 1.10 | 0.73–1.65 | 0.644 | 1.05 | 0.76–1.45 | 0.774 | 0.90 | 0.66–1.24 | 0.516 | 0.84 | 0.58–1.23 | 0.355 |
| Chemotherapy within a month | — | — | — | — | — | — | 0.94 | 0.72–1.21 | 0.611 | — | — | — | — | — | — |
| Oxygen therapy use | — | — | — | 0.80 | 0.58–1.10 | 0.161 | — | — | — | 0.96 | 0.77–1.21 | 0.748 | — | — | — |
| Antipsychotic use | — | — | — | — | — | — | 0.85 | 0.67–1.09 | 0.194 | 0.89 | 0.63–1.24 | 0.477 | 0.90 | 0.66–1.23 | 0.494 |
| Psychotropic use | — | — | — | 0.99 | 0.77–1.28 | 0.965 | 1.04 | 0.86–1.26 | 0.711 | 1.04 | 0.85–1.29 | 0.698 | 1.14 | 0.92–1.41 | 0.227 |
| Treatment at one week before death | |||||||||||||||
| Opioid dosage (OME ≥60 mg/day) | 0.90 | 0.61–1.35 | 0.592 | 1.03 | 0.60–1.77 | 0.916 | 0.99 | 0.70–1.38 | 0.929 | 1.00 | 0.68–1.47 | 0.987 | 0.94 | 0.65–1.36 | 0.745 |
| Parenteral hydration: 0 mL/day | — | — | — | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | Ref. | — | — | — |
| Parenteral hydration: 1–999 mL/day | — | — | — | 0.95 | 0.38–2.37 | 0.905 | 0.93 | 0.68–1.29 | 0.661 | 1.01 | 0.70–1.46 | 0.961 | — | — | — |
| Parenteral hydration: ≥1000 mL/day | — | — | — | 2.59 | 0.43–15.56 | 0.262 | 0.97 | 0.35–2.66 | 0.950 | 0.83 | 0.34–2.00 | 0.653 | — | — | — |
CI, confidence interval; OR, odds ratio.