Factors associated with length of hospital stay and discharge outcomes in palliative care: a retrospective study

Introduction: This study aimed to investigate the clinical and sociodemographic characteristics, length of stay, and prognosis of patients admitted to a Palliative Care Center.Methods: This retrospective study included 200 patients followed and treated at the Palliative Care Center of Izmir Katip Celebi University Atatürk Training and Research Hospital between November 1, 2023, and November 1, 2024. Data were obtained from the Hospital Information Management System and archived patient records. Patients' admission complaints, demographic characteristics, comorbidities, nutritional status, presence of pressure ulcers, and discharge outcomes were recorded using a form developed by the researchers. The distribution of continuous variables was assessed using the Shapiro–Wilk test. Due to the non-normal distribution and considerable variability in length of hospital stay, non-parametric statistical methods were used for the relevant group comparisons. Multivariable generalized linear regression and binary logistic regression analyses were performed to identify factors independently associated with length of hospital stay and discharge outcome, respectively.Results: A total of 200 patients were included in the study (47.5% male, 52.5% female), with a median age of 74 years (range: 24–107) and a median hospital stay of 16 days (range: 2–205). The most common admission reason was inadequate oral intake (52%), followed by poor general condition (44.5%). The three most frequent comorbidities were malignancy (60%, n=120), hypertension (56.5%, n=113), and diabetes mellitus (35.5%, n=71). Malignancy was observed in 59.17% of male and 40.83% of female patients. Factors prolonging hospital stay included antibiotic use, presence of infection, neurodegenerative disease, and pressure ulcers, whereas the presence of malignancy, admission due to poor general condition, and parenteral nutrition were associated with shorter hospital stay. Regarding discharge outcomes, 76 patients (38%) were discharged, 67 (33.5%) were transferred to intensive care, and 57 (28.5%) died. Factors significantly associated with discharge status included malignancy (p=0.002), admission due to poor general condition (p=0.001), presence of cerebrovascular disease (p=0.008), increased number of medications (p=0.001), type of nutrition (p=0.001), and opioid use (p=0.001). In multivariable analysis, pressure ulcer status (p=0.008) and nutritional status (p<0.001) remained independently associated with length of hospital stay. For discharge outcome, age, pain at admission, pressure-ulcer care at admission, number of medications, diabetes mellitus, cerebrovascular disease, opioid use, and nutritional status overall were independently associated with the outcome (p<0.05).Conclusion: The increasing number of elderly and advanced-stage cancer patients has led to a marked rise in the demand for palliative care centers. In this context, the systematic documentation of patients' detailed medical histories, symptom profiles, comorbidities, nutritional status, pain levels, and conditions such as pressure ulcers, along with prognostic factors, may significantly contribute to the development of effective and targeted approaches in palliative care.