Table 1. Participants' Characteristics by End-Of-Life (EOL) Care Discussion (N=603).
| Total sample N (%) | Patient discussed EOL care preferences with physician | p-value | ||
|---|---|---|---|---|
| Yes | No | |||
| No. of cases; N (%) | 603 | 188 (31.2) | 415 (68.8) | |
| Age; mean (SD), yr | 59.0 (13.2) | 59.8 (12.9) | 58.6 (13.2) | 0.28 |
| Sex; N (%) | 0.86 | |||
| Male | 308 (51.2) | 95 (50.5) | 213 (51.3) | |
| Female | 295 (48.9) | 93 (49.5) | 202 (48.7) | |
| Race/Ethnicity; N (%) | 0.26 a | |||
| White, non-Hispanic | 430 (71.3) | 139 (73.9) | 291 (70.1) | 0.34 |
| Black, non-Hispanic | 89 (14.8) | 26 (13.8) | 63 (15.2) | 0.66 |
| Hispanic | 72 (11.9) | 22 (11.7) | 50 (12.1) | 0.90 |
| Asian | 10 (1.7) | 0 (0) | 10 (2.4) | 0.04 b |
| Other | 2 (0.3) | 1 (0.5) | 1 (0.2) | 0.53 |
| Marital status; N (%) | 0.27 | |||
| Married | 380 (64.1) | 112 (60.9) | 268 (65.5) | |
| Unmarried | 213 (35.9) | 73 (39.1) | 141 (34.5) | |
| Education; mean (SD), yr | 12.8 (4.0) | 12.8 (3.7) | 12.81 (4.1) | 0.97 |
| Health insurance; N (%) | 0.12 | |||
| Insured | 416 (69.1) | 119 (64.7) | 293 (71.1) | |
| Uninsured | 184 (30.9) | 65 (35.3) | 119 (28.9) | |
| Religion; N (%) | 0.97 a | |||
| Catholic | 259 (43.0) | 82 (43.6) | 177 (42.8) | 0.84 |
| Protestant | 112 (18.6) | 33 (17.6) | 79 (19.1) | 0.66 |
| Jewish | 19 (3.2) | 5 (2.7) | 14 (3.4) | 0.64 |
| Baptist | 67 (11.1) | 23 (12.2) | 44 (10.6) | 0.56 |
| Other | 99 (16.5) | 28 (14.9) | 71 (17.2) | 0.49 |
| None | 32 (5.3) | 11 (5.9) | 21 (5.1) | 0.69 |
| Cancer type; N (%) | 0.80 | |||
| Breast | 64 (10.8) | 21 (11.5) | 43 (10.5) | 0.73 |
| Colorectal | 68 (11.5) | 25 (13.7) | 43 (10.5) | 0.27 |
| Pancreatic | 50 (8.5) | 15 (8.2) | 35 (8.6) | 0.88 |
| Other GI | 74 (12.5) | 20 (10.9) | 54 (13.2) | 0.44 |
| Lung | 144 (24.3) | 41 (22.4) | 103 (25.2) | 0.47 |
| Other c | 203 (33.7) | 66 (34.1) | 137 (33.0) | 0.61 |
| Health status; mean (SD) | ||||
| Karnofsky score | 67.3 (16.8) | 61.8 (16.7) | 69.8 (16.2) | <0.0001 |
| Charlson comorbidity | 8.2 (2.7) | 8.7 (2.8) | 8.0 (2.6) | 0.002 |
| McGill physical subscale d | 6.1 (2.7) | 4.4 (2.8) | 3.7 (2.6) | 0.002 |
| McGill symptom subscale d | 11.3 (4.4) | 9.9 (4.3) | 8.1 (4.4) | <0.0001 |
| Recruitment site; N (%) | <0.0001 | |||
| Yale Cancer Center | 153 (26.7) | 20 (11.4) | 133 (33.5) | <0.0001 |
| VACCC e | 21 (3.7) | 10 (5.7) | 11 (2.8) | 0.09 |
| Parkland Hospital f | 178 (31.1) | 67 (38.1) | 111 (28.0) | 0.02 |
| Simmons Center g | 40 (7.0) | 8 (4.6) | 32 (8.1) | 0.13 |
| DFCI/MGH h | 47 (8.2) | 13 (7.4) | 34 (8.6) | 0.64 |
| NHOH i | 131 (22.9) | 57 (32.4) | 74 (18.6) | 0.0003 |
| Illness Acknowledgement | ||||
| Wants to know life expectancy | 426 (71.6) | 149 (80.1) | 277 (67.7) | 0.002 |
| Trusts physician | 591 (98.8) | 185 (98.9) | 406 (98.8) | 1.00 b |
| Acknowledge yourself to be terminal ill | 203 (34.3) | 95 (52.2) | 108 (26.3) | <0.0001 |
| Treatment preferences | ||||
| Values life extension over comfort | 158 (29.0) | 25 (14.0) | 133 (36.2) | <0.0001 |
| Prefers everything possible to extend life for a few days | 122 (20.7) | 29 (15.6) | 93 (23.1) | 0.04 |
| Prefers chemotherapy to extend life | 311 (52.7) | 87 (47.0) | 224 (55.3) | 0.06 |
| Prefers ventilator to extend life | 142 (24.1) | 36 (19.3) | 106 (26.4) | 0.06 |
| Preference against death in ICU | 221 (38.2) | 90 (48.9) | 131 (33.3) | 0.0003 |
Note: Italicized rows represent continuous measures; mean and standard deviation (SD) shown.
a
Cochran-Mantel-Haenszel statistics due to small cells.
b
Fisher's exact test due to small cells.
c
The remaining patients had cancer types representing <5% of the sample.
d
McGill Quality of Life Questionnaire Items (scale 0-10) where 0 is desirable and 10 is undesirable.
e
VACCC=Veterans Affairs Connecticut Healthcare System Comprehensive Cancer Clinics.
f
Parkland Hospital=Parkland Hospital Palliative Care Service, Texas.
g
Simmons Center=Simmons Comprehensive Cancer Center, Texas.
h
DFCI/MGH =Dana-Farber Cancer Institute and Massachusetts General Hospital.
i
NHOH=New Hampshire Oncology Hematology.