Morbidity and mortality in patients with cancer who become nonambulatory after spinal cord compression: A case series on end-of-life care

Jocelin Huang, Aminah Jatoi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Few studies have focused on the outcomes of nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. The purpose of this study was to review the morbidity and mortality suffered by these patients. Methods: Over a 10-year period (1996-2006), a retrospective review was undertaken to assess the outcomes of 39 nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. Results: Treatment for cord compression included corticosteroids (n=33), radiation (n=25), and surgical decompression (n=13). Nonetheless, 23 patients (59%) required bowel and/or bladder catheterization, and 33 (85%) required pain medications. Twenty-five (64%) did not regain ambulation. Only 13 patients (33%) went home without assistance. In contrast, 10 (26%) were transferred to a nursing home, 6 (15%) were sent home with hospice, 5 (13%) went home with home health care, and 1 (3%) was moved to a hospice inpatient facility. At the time of this report, all patients had died with a median survival of 76 days (range, 4-1975 days). Long-term survivors who lived beyond a year were primarily patients who had regained ambulation. Conclusion: Metastatic cord compression causes severe morbidity and compromised survival in patients who become nonambulatory. Future palliative care efforts should focus on further characterizing and addressing these needs.

Original languageEnglish (US)
Pages (from-to)219-222
Number of pages4
JournalJournal of Palliative Medicine
Volume12
Issue number3
DOIs
StatePublished - Mar 1 2009

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Spinal Cord Compression
Terminal Care
Morbidity
Mortality
Neoplasms
Hospices
Walking
Surgical Decompression
Survival
Home Care Services
Nursing Homes
Palliative Care
Catheterization
Survivors
Inpatients
Adrenal Cortex Hormones
Urinary Bladder
Radiation
Delivery of Health Care
Pain

ASJC Scopus subject areas

  • Medicine(all)
  • Anesthesiology and Pain Medicine
  • Nursing(all)

Cite this

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title = "Morbidity and mortality in patients with cancer who become nonambulatory after spinal cord compression: A case series on end-of-life care",
abstract = "Background: Few studies have focused on the outcomes of nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. The purpose of this study was to review the morbidity and mortality suffered by these patients. Methods: Over a 10-year period (1996-2006), a retrospective review was undertaken to assess the outcomes of 39 nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. Results: Treatment for cord compression included corticosteroids (n=33), radiation (n=25), and surgical decompression (n=13). Nonetheless, 23 patients (59{\%}) required bowel and/or bladder catheterization, and 33 (85{\%}) required pain medications. Twenty-five (64{\%}) did not regain ambulation. Only 13 patients (33{\%}) went home without assistance. In contrast, 10 (26{\%}) were transferred to a nursing home, 6 (15{\%}) were sent home with hospice, 5 (13{\%}) went home with home health care, and 1 (3{\%}) was moved to a hospice inpatient facility. At the time of this report, all patients had died with a median survival of 76 days (range, 4-1975 days). Long-term survivors who lived beyond a year were primarily patients who had regained ambulation. Conclusion: Metastatic cord compression causes severe morbidity and compromised survival in patients who become nonambulatory. Future palliative care efforts should focus on further characterizing and addressing these needs.",
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AB - Background: Few studies have focused on the outcomes of nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. The purpose of this study was to review the morbidity and mortality suffered by these patients. Methods: Over a 10-year period (1996-2006), a retrospective review was undertaken to assess the outcomes of 39 nonambulatory patients diagnosed with spinal cord compression from metastatic cancer. Results: Treatment for cord compression included corticosteroids (n=33), radiation (n=25), and surgical decompression (n=13). Nonetheless, 23 patients (59%) required bowel and/or bladder catheterization, and 33 (85%) required pain medications. Twenty-five (64%) did not regain ambulation. Only 13 patients (33%) went home without assistance. In contrast, 10 (26%) were transferred to a nursing home, 6 (15%) were sent home with hospice, 5 (13%) went home with home health care, and 1 (3%) was moved to a hospice inpatient facility. At the time of this report, all patients had died with a median survival of 76 days (range, 4-1975 days). Long-term survivors who lived beyond a year were primarily patients who had regained ambulation. Conclusion: Metastatic cord compression causes severe morbidity and compromised survival in patients who become nonambulatory. Future palliative care efforts should focus on further characterizing and addressing these needs.

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