Goals of Care and End-of-Life Decision Making for Hospitalized Patients at a Canadian Tertiary Care Cancer Center

Regression models of investigation frequency during hospitalization. The number of investigations per week was plotted for 118 patients over the hospital course. Both linear regression and Poisson regression models revealed a significant trend of decreasing frequency of investigations over time.

Appropriateness of investigations based on the type of investigation. The appropriateness of investigations was a measure of the proportion of tests for which there was a clear indication (diagnosis, treatment, or monitoring). Imaging investigations and liver function tests were associated with a higher percentage of patients with higher appropriateness scores compared to CBC and electrolytes.

Decision milestones from date of death. Box plot displaying the number of days from death to admission, last chemotherapy treatment (only for patients who received chemotherapy during admission), last dose of radiation (only for patients who received radiation during admission), last investigation, and establishment of goals of care including DNR, supportive care plan, and diagnosis of dying. The numbers indicate the median number of days from each of the respective decision points to the date of death.