Table 3.
Adjusted Odds of Individual Procedure Use in the Last Six Months of Life (to be included as electronic supplement)
| Intubation and mechanical ventilation |
Gastrostomy tube insertion |
Enteral or parenteral nutrition |
Cardiopulmonary resuscitation |
Tracheostomy | |
|---|---|---|---|---|---|
| Number of subjects undergoing procedure | 369 | 139 | 126 | 61 | 44 |
| Subject characteristics | |||||
| Age (reference = 74 or younger) | |||||
| 75–84 | 0.82 (0.62 – 1.10) | 1.22 (0.72 – 2.06) | 0.71 (0.42 – 1.21) | 0.72 (0.37 – 1.38) | 0.80 (0.38 – 1.67) |
| 85–94 | 0.58 (0.42 – 0.80) | 1.42 (0.82 – 2.43) | 0.88 (0.52 – 1.50) | 0.74 (0.37 – 1.51) | 0.44 (0.18 – 1.07) |
| 95+ | 0.39 (0.22 – 0.70) | 1.00 (0.45 – 2.26) | 0.68 (0.31 – 1.49) | 0.31 (0.07 – 1.43) | N/Aa |
| Female | 0.87 (0.69 – 1.11) | 0.79 (0.54 – 1.15) | 1.24 (0.83 – 1.84) | 0.76 (0.44 – 1.32) | 0.72 (0.38 – 1.37) |
| Race (reference = non-Hispanic white) | |||||
| Black | 1.62 (1.18 – 2.22) | 2.85 (1.77 – 4.58) | 1.42 (0.85 – 2.38) | 1.66 (0.84 – 3.27) | 2.16 (0.94 – 4.96) |
| Hispanic | 0.95 (0.57 – 1.58) | 3.41 (1.83 – 6.36) | 1.80 (0.89 – 3.65) | 0.73 (0.23 – 2.25) | 2.01 (0.67 – 6.01) |
| Other | 1.48 (0.66 – 3.34) | 2.11 (0.63 – 7.06) | 2.14 (0.73 – 6.31) | 1.92 (0.42 – 8.66) | 1.56 (0.19 – 13.02) |
| Nursing home resident | 0.58 (0.38 – 0.88) | 0.72 (0.39 – 1.31) | 0.97 (0.56 – 1.69) | 0.46 (0.16 – 1.31) | 0.16 (0.02 – 1.08) |
| Religion is “very important” | 1.14 (0.88 – 1.48) | 0.73 (0.50 – 1.08) | 1.02 (0.67 – 1.56) | 0.81 (0.45 – 1.46) | 1.12 (0.51 – 2.43) |
| Relatives nearby | 0.85 (0.67 – 1.09) | 0.75 (0.48 – 1.17) | 0.99 (0.68 – 1.45) | 0.94 (0.54 – 1.64) | 1.48 (0.78 – 2.81) |
| Advance directive | 0.66 (0.51 – 0.85) | 1.02 (0.68 – 1.52) | 0.81 (0.54 – 1.22) | 0.41 (0.23 – 0.74) | 0.93 (0.45 – 1.92) |
| Needs assistance with at least one ADLb | 0.78 (0.58 – 1.03) | 1.30 (0.83 – 2.03) | 1.42 (0.92 – 2.21) | 1.11 (0.59 – 2.08) | 1.29 (0.60 – 2.75) |
| Regional factors | |||||
| Hospital Care Intensity (HCI) Index | 2.25 (1.45 – 3.49) | 2.04 (1.07 – 3.89) | 2.50 (1.28 – 4.88) | 3.33 (1.28 – 8.66) | 8.04 (2.79 – 23.20) |
| Acute hospital beds per 1,000 residents | 1.13 (0.89 – 1.43) | 1.37 (0.97 – 1.95) | 1.27 (0.87 – 1.85) | 0.82 (0.47 – 1.43) | 0.77 (0.39 – 1.54) |
| Specialists per 100,000 residents | 1.00 (1.00 – 1.01) | 1.00 (0.99 – 1.01) | 1.01 (1.01 – 1.02) | 0.99 (0.98 – 1.01) | 1.00 (0.99 – 1.02) |
Note: Bold indicates statistical significance at p<0.05. Models also adjusted for: chronic kidney disease, COPD, CHF, diabetes, hip fracture, depression, stroke or transient ischemic attack, ischemic heart disease, Alzheimer’s disease, cancer and comorbidity score.
a
No individuals in the 95+ category had a tracheostomy
b
Activity of Daily Living27