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Scientific Research

Observational Science

RPD111 - Palliative Care and End-of-Life Resource Utilization in Pancreatic Cancer: A Nationwide Inpatient Cohort Study

Thursday, March 5, 2026
2:30pm - 4:00pm PST
Location: Room 28 DE
Disclosure(s):
Kibwey Roderick Andwele Peterkin, MBBS: No financial relationships to disclose
Carina-Leigh Lezama, MD: No financial relationships to disclose
Shani McLean, MD, MPH: No financial relationships to disclose
Abiolah Telesford, MD: No financial relationships to disclose
Elaine Oliveira, MD: No financial relationships to disclose
Andrew Zbyrko, MD: No financial relationships to disclose
Elizabeth Horn Prsic, MD: No relevant disclosure to display
Chantelle Harry, MD: No financial relationships to disclose
Key Message : Among patients with pancreatic cancer who died inpatient, palliative care (PC) did not reduce length of stay or hospital charges but was associated with decreased use of invasive interventions. This work highlights the role of PC in promoting goal-concordant care and limiting medically-aggressive interventions near the end of life.

Abstract: Background
Pancreatic cancer accounts for approximately 3% of all cancers in the United States but remains the third leading cause of cancer-related mortality [1,2]. This study evaluates inpatient palliative care (PC) encounters and its association with healthcare resource utilization and end-of-life interventions among hospitalized patients with pancreatic cancer who died during their admission.

Methods
A retrospective cohort study was conducted using the National Inpatient Sample (2016–2022). Adult patients hospitalized with pancreatic cancer were identified using ICD-10 codes, and the cohort was restricted to inpatient decedents. Patients were stratified by receipt of PC during hospitalization. Primary outcomes included length of stay (LOS) and total hospital charges (THC). Secondary outcomes were receipt of medically aggressive interventions (specifically, mechanical ventilation, vasopressor use, and/or central venous catheter [CVC] placement), tracheostomy, percutaneous endoscopic gastrostomy (PEG) placement, total parenteral nutrition (TPN), pancreatic resection, and endoscopic retrograde cholangiopancreatography (ERCP). Multivariate regression models were used for analysis.

Results
A total of 3,141 patients were included, of whom 2,031 (64.7%) received PC. Multivariable analysis showed no significant differences in LOS or THC between groups. However, PC was associated with lower odds of receiving medically aggressive care (adjusted odds ratio [aOR] 0.66, 95% confidence interval [CI] 0.50–0.85; p< 0.01). In individual analyses, PC was associated with lower odds of mechanical ventilation (aOR 0.71, 95% CI 0.52–0.96; p< 0.03) and CVC placement (aOR 0.56, 95% CI 0.35–0.91; p< 0.02). No significant differences were observed in rates of tracheostomy, PEG, TPN initiation, pancreatic resection, or ERCP.

Conclusion
Among hospitalized patients with pancreatic cancer who died during admission, inpatient palliative care was not associated with differences in length of stay or hospital charges but was linked to significantly lower use of medically aggressive interventions. These findings highlight the role of palliative care in fostering goal-concordant decision-making and limiting medically aggressive interventions near the end of life.

References: 1. American Cancer Society. (2025, September). Facts About Pancreatic Cancer. Cancer. https://www.cancer.org/cancer/types/pancreatic-cancer/about/key-statistics.html.

2. National Cancer Institute. (2025, September). Cancer Stat Facts: Pancreatic Cancer. U.S. Department of Health and Human Services National Institutes of Health. https://seer.cancer.gov/statfacts/html/pancreas.html.

Learning Objectives:

  • Apply knowledge of inpatient palliative care to identify hospitalized pancreatic cancer patients approaching end of life who may benefit from reduced invasive interventions.
  • Utilize data on palliative care’s impact on resource use to guide clinical decision-making and implement strategies that align interventions with patient-centered goals near death.