Palliative Care in Patients With Advanced Cancer: Impact on Reducing Critical Care Therapies

Tuesday, March 24, 2026

11:15 AM - 12:15 PM Central Time

Location: Connections Central - RST 16

Ivan Huespe, MD

Buenos Aires, Argentina

Disclosure(s): No relevant financial relationship(s) to disclose.
VM

Verónica A. Monzón, N/A

MD
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Disclosure information not submitted.
SD

Sabrina A. Di Stefano, N/A

MD
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Disclosure information not submitted.
AG

Alicia Gira, n/a

MD
Hospital Austral, Argentina

Disclosure information not submitted.
PP

Pablo Pratesi, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
TL

Tomas Lagos, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
NM

Najun Matías, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
MP

Melina Pochettino, N/A

MD
Hospital Italiano de San Justo “Agustín Rocca”

Disclosure information not submitted.
BL

Bruno Leone, N/A

MD
Hospital Alemán

Disclosure information not submitted.
DI

Daniel Ivulich, N/A

MD
Hospital Alemán

Disclosure information not submitted.
HH

Hellen Huerta, N/A

MD
Hospital Alemán

Disclosure information not submitted.
LV

Luis Alberto Vélez Román, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
MV

Mariana Vaena, N/A

MD
Hospital Italiano de Buenos Aires

Disclosure information not submitted.
GO

Gustavo A. Olaizola, N/A

MD
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Disclosure information not submitted.
EB

Estefanía Bellone, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
�P

Álvaro Pérez de Andes, N/A

MD
Hospital Universitario Austral

Disclosure information not submitted.
SB

Susana A. Bauque, N/A

MD
Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

Disclosure information not submitted.
JO

Javier Osatnik, N/A

MD
Hospital Alemán

Disclosure information not submitted.

Introduction: Aggressive life-sustaining measures near the end of life can conflict with the preferences of patients with advanced cancer, yet palliative-care (PC) integration inside intensive care units (ICUs) is uncommon in middle-income countries. We examined whether PC involvement—either before or during the ICU stay—reduces critical-care therapies (CCTs) and shortens lengths of stay in terminal oncology patients.

Methods: We performed a multicentre retrospective cohort study in three Argentine tertiary hospitals (2010-2024). Adults with stage III–IV solid tumours who died after a first ICU admission were included. Exposure was any formal PC consultation. The primary endpoint was receipt of ≥1 CCT: invasive mechanical ventilation, dialysis, enteral tube feeding, total parenteral nutrition or tracheostomy. Secondary endpoints were ICU and hospital length of stay (LOS). To adjust for confounding, we built inverse-probability-of-treatment weights from age, sex, APACHE II score, tumour type, prior hospitalisations and major comorbidities, trimming extreme weights (>10). Weighted logistic regression estimated the association between PC and CCT use; zero-inflated negative-binomial models analysed LOS.

Results: Of 2 571 screened patients, 292 met eligibility (median age 65 yr; 62 % male). Only 68 (23 %) received PC—just 18 % before ICU entry. Overall, 197 (68 %) underwent at least one CCT. CCT exposure was lower with PC (54 % vs 72 %, p< 0.01) and remained so after weighting (OR 0.47, 95 % CI 0.33–0.66). Invasive ventilation (41 % vs 59 %) and enteral feeding (41 % vs 59 %) showed the largest absolute reductions. Weighted hospital LOS was 33 % shorter with PC (IRR 0.67, 95 % CI 0.57–0.89), whereas ICU LOS did not differ (IRR 1.13, p = 0.22). Covariate balance was adequate (all standardised mean differences < 0.10).

Conclusions: In this first Latin-American multicentre cohort, PC consultation halved the odds of receiving aggressive CCTs and cut hospital stay by one-third without prolonging ICU time. Embedding systematic, early PC triggers within ICU workflows could align treatments with patient goals, lessen non-beneficial interventions and relieve resource strain. Prospective studies should identify barriers to timely PC referral and test structured consultation algorithms.