Individuals With Cancer and an ICD Receive More Aggressive End-of-Life Care

FRIDAY, Jan. 10, 2025 (HealthDay News) — Older cancer decedents with an implantable cardioverter defibrillator (ICD) receive more aggressive end-of-life care, according to a study published online Nov. 14 in Cancer.

Megan A. Mullins, Ph.D., M.P.H., from the UT Southwestern Medical Center in Dallas, and colleagues examined ICD prevalence and the association with aggressive end-of-life care among individuals with breast, colorectal, and pancreatic cancer. The analyses included 37,306 Medicare beneficiaries aged 66 years and older with stage 3 or 4 cancer who died between 2005 and 2016.

The researchers found that 6 percent of the cancer decedents had an ICD. More individuals with versus without an ICD died in the hospital (31 versus 25 percent). Overall, 46 percent of individuals with an ICD had device programming or interrogation visits that could have provided an opportunity for device discussion. Other than chemotherapy, ICD presence was associated with higher odds of every indicator of aggressive end-of-life care in adjusted models.

“Though individuals with cancer who had an ICD were more likely to receive all indicators of aggressive end‐of‐life care other than chemotherapy, nearly half of the individuals with an ICD had a device programming encounter in their last six months of life that could serve as an opportunity to discuss goals of care and device deactivation,” the authors write.

Two authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text