Factors determining the place of death of patients with advanced cancer in Egypt and the development of a predictive model / Ahmed Mohammed Ahmed Hammad ; Supervised Omar Elfarouk Othman Zaki , Samy Abdelrazek Alsirafy , Noha Yehia Abdou Ibrahim

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Oncology (Clinical )

Background: Little is known about the place of death of cancer patients in Eastern Mediterranean countries including Egypt, where palliative care is underdeveloped. Identifying the preferred place of death (PPoD) is important for the development of appropriate palliative care models in these countries. Objectives: To know the PPoD of Egyptian patients with incurable cancer and their family caregivers (FCGs) and to determine factors that may impact their preferences. Methods: A prospective observational study that included 311 dyads of patients with incurable cancer and one of their FCGs. A questionnaire was designed to collect data about the characteristics of patients and FCGs as well as their preferences. The answer for the PPoD question was: home, hospital or other. Results: The majority of dyads (280/311, 90%) answered the PPoD question. Home was the PPoD in 93.2% of patients and 90.4% of FCGs (p=0.218). The congruence between patients{u2019} and FCGs{u2019} PPoD was 92.8% (Kappa = 0.528). In multivariate analysis, poorer performance status (ECOG 3 or 4) and full employment of FCGs associated significantly with patients{u2019} preference to die in hospital (OR= 3 [95%CI: 1.02-8.82], p=0.046 and OR=2.88, [95%CI: 1.05-7.87], p=0.039; respectively) while poorer performance status only was associated with FCGs{u2019} preference to die in hospital (OR=2.97 [95% CI: 1.23-7.16], p=0.015)

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