Table 2.
Factors associated to artificial nutrition use in the last 7 and 31 d before death (univariate analysis)
| The last 7 d before death | The last 31 d before death | |||||
|---|---|---|---|---|---|---|
| N = 11 723 (2.9%) | OR (95% CI) | P | N = 20 429 (5.1%) | OR (95% CI) | P | |
| N (%) | N (%) | |||||
| Sex | ||||||
| Women (ref) | 3932 (2.4) | 7252 (4.5) | ||||
| Men | 7591 (3.2) | 1.34 (1.29‐1.39) | <.001 | 13 177 (5.6) | 1.26 (1.23‐1.3) | <.001 |
| Age at death (years) | ||||||
| <60 (ref) | 2904 (3.8) | 5223 (6.7) | ||||
| [60;70] | 3691 (3.6) | 0.96 (0.91‐1.01) | .079 | 6495 (6.3) | 0.93 (0.90‐0.97) | <.001 |
| [70;80] | 3153 (3.1) | 0.82 (0.78‐0.87) | <.001 | 5486 (5.4) | 0.79 (0.76‐0.82) | <.001 |
| ≥80 | 1775 (1.5) | 0.39 (0.37‐0.42) | <.001 | 3225 (2.8) | 0.39 (0.37‐0.41) | <.001 |
| Year of death | ||||||
| 2013 (ref) | 2869 (3.0) | 5019 (5.2) | ||||
| 2014 | 2908 (2.9) | 0.99 (0.94‐1.05) | .77 | 5216 (5.3) | 1.02 (0.98‐1.06) | .370 |
| 2015 | 2744 (2.7) | 0.92 (0.87‐0.97) | .002 | 4977 (5.0) | 0.95 (0.92‐0.99) | .024 |
| 2016 | 3002 (2.9) | 0.99 (0.94‐1.04) | .630 | 5217 (5.1) | 0.98 (0.94‐1.02) | .323 |
| Hospitalization stay duration (days) | ||||||
| ≤7 (ref) | 3895 (2.5) | 5924 (3.8) | ||||
| [8‐31] | 6002 (3.1) | 1.25 (1.2‐1.3) | <.001 | 11 492 (5.9) | 1.60 (1.55‐1.65) | <.001 |
| >31 | 1626 (3.4) | 1.38 (1.3‐1.46) | <.001 | 3013 (6.3) | 1.71 (1.63‐1.79) | <.001 |
| Hospital type | ||||||
| Non speciality | 7330 (2.4) | 13 334 (4.4) | ||||
| Speciality | 4193 (4.3) | 1.78 (1.71‐1.85) | 7095 (7.2) | 1.67 (1.62‐1.72) | <.001 | |
| Cancer localization | ||||||
| NDHANa (ref) | 6251 (2.5) | 10 587 (4.2) | ||||
| Digestiveb | 4230 (3.2) | 1.31 (1.26‐1.36) | <.001 | 7735 (5.9) | 1.43 (1.39‐1.47) | <.001 |
| Head and neck | 1042 (6.2) | 2.57 (2.4‐2.75) | <.001 | 2107 (12.5) | 3.23 (3.08‐3.40) | <.001 |
| Metastasis | ||||||
| (ref: no) | 7044 (2.8) | 0.87 (0.84‐0.9) | <.001 | 12 658 (4.9) | 0.90 (0.87‐0.93) | <.001 |
| Comorbidities (Charlson)c | ||||||
| Absence (ref) | 3930 (2.5) | 7341 (4.6) | ||||
| 1 or 2 | 4363 (3.1) | 1.27 (1.21‐1.32) | <.001 | 7585 (5.4) | 1.18 (1.14‐1.22) | <.001 |
| 3 or 4 | 2035 (3.2) | 1.3 (1.24‐1.38) | <.001 | 3474 (5.4) | 1.19 (1.15‐1.24) | <.001 |
| ≥5 | 1195 (3.6) | 1.5 (1.4‐1.6) | <.001 | 2029 (6.2) | 1.37 (1.3‐1.44) | <.001 |
| Malnutrition | ||||||
| Absence (ref) | 6572 (2.4) | 9072 (3.6) | ||||
| Mild | 268 (6.1) | 2.68 (2.36‐3.04) | <.001 | 533 (9.2) | 2.71 (2.47‐2.97) | <.001 |
| Moderate | 1343 (3.9) | 1.69 (1.60‐1.80) | <.001 | 2930 (6.7) | 1.93 (1.84‐2.01) | <.001 |
| Severe | 3037 (4.1) | 1.79 (1.71‐1.87) | <.001 | 7294 (8.1) | 2.35 (2.28‐2.42) | <.001 |
| Other casesd | 303 (4.3) | 1.85 (1.65‐2.08) | <.001 | 600 (7.2) | 2.06 (1.89‐2.25) | <.001 |
| Presence of specific situation(s)e, f | ||||||
| No (ref) | 3070 (2.1) | 3722 (3.3) | ||||
| At least oneg | 8453 (3.4) | 1.66 (1.59‐1.73) | <.001 | 16 707 (5.9) | 1.86 (1.79‐1.93) | <.001 |
| Cachexia | ||||||
| (ref: no) | 628 (3.3) | 1.14 (1.05‐1.23) | .002 | 1451 (6.6) | 1.33 (1.26‐1.41) | <.001 |
| Anorexia | ||||||
| (ref: no) | 673 (2.8) | 0.95 (0.88‐1.02) | .175 | 1807 (5.7) | 1.12 (1.07‐1.18) | <.001 |
| Metabolic disorders | ||||||
| (ref: no) | 4578 (4.5) | 1.99 (1.92‐2.07) | <.001 | 9121 (0.07) | 1.86 (1.81‐1.91) | <.001 |
| Mucositis/stomatitis | ||||||
| (ref: no) | 617 (3.3) | 1.16 (1.06‐1.26) | <.001 | 1591 (6.8) | 1.39 (1.32‐1.46) | <.001 |
| Hepatic disorders | ||||||
| (ref: no) | 1575 (4.3) | 1.58 (1.49‐1.66) | <.001 | 2689 (6.6) | 1.35 (1.29‐1.41) | <.001 |
| Digestive symptoms | ||||||
| (ref: no) | 2711 (3.5) | 1.28 (1.22‐1.33) | <.001 | 6529 (6.8) | 1.51 (1.46‐1.55) | <.001 |
| Respiratory symptoms | ||||||
| (ref: no) | 1604 (3.5) | 1.26 (1.2‐1.33) | <.001 | 3459 (6.3) | 1.3 (1.25‐1.35) | <.001 |
| Skin ulceration | ||||||
| (ref: no) | 1732 (3.2) | 1.12 (1.06‐1.18) | <.001 | 3771 (6.2) | 1.28 (1.23‐1.32) | <.001 |
| Dementia | ||||||
| (ref: no) | 208 (1.5) | 0.5 (0.44‐0.58) | <.001 | 446 (2.8) | 0.52 (0.47‐0.57) | <.001 |
| Chemotherapy usef | ||||||
| (ref: no) | 1236 (3.9) | 1.4 (1.31‐1.48) | <.001 | 5406 (6.3) | 1.34 (1.3‐1.38) | <.001 |
| Palliative care usef | ||||||
| (ref: no) | 6492 (2.2) | 0.43 (0.41‐0.45) | <.001 | 13 563 (4.5) | 0.62 (0.6‐0.64) | <.001 |
Bold values: P‐values < .05.
Abbreviations: OR (95% CI), odd ratio with the 95% confidence interval; Ref, modality of reference.
NDHAN: Non‐digestive and non‐head‐and‐neck cancers.
Digestive cancers: oesophageal, pancreas, and other digestive localizations.
Charlson modified score (excluding malignancies/metastasis).
Protein energy malnutrition non‐defined according to severity.
Biological and/or clinical situations potentially source of prescription of artificial nutrition.
The last 7 or 31 d depending on the endpoint (last 7 or 31 d before death, respectively).
Cachexia and/or anorexia and/or metabolic disorders and/or mucositis/stomatitis and/or hepatic disorders and/or digestive symptoms and/or respiratory symptoms and/or skin ulceration.