# Epidemiology and palliative care of in-patient cerebral metastases cases in Germany

## TL;DR

This study examines the treatment and palliative care of cerebral metastases patients in German hospitals in 2022, highlighting high mortality and limited use of specialized palliative care.

## Contribution

The study provides the first benchmark for inpatient cerebral metastases care in Germany, revealing gaps in palliative care utilization.

## Key findings

- 14.8% of CM patients received specialized inpatient palliative care.
- Hospital mortality was 13.1%, with 42.2% of these patients having received palliative care.
- Lung cancer was the most common primary tumor in CM cases (61.6%).

## Abstract

Cerebral metastases (CM) are the most common intracranial neoplasms, significantly impacting patient quality-of-life. Despite advancements in diagnostics and therapeutics, the burden remains high. This study evaluates inpatient management, palliative care use, and mortality outcomes for CM patients in German hospitals in 2022.

A cross-sectional analysis was conducted on 71,787 inpatient cases involving adult CM and leptomeningeal malignancies patients in German hospitals in 2022. Data submitted by hospitals according to §21 of the Hospital Remuneration Act were analyzed, focusing on demographic data, primary tumor types, treatment methods, participation in palliative care, and discharge outcomes.

Among the 71,787 cases, 53.4% were patients aged 65 years or older. Malignant lung tumors were present in 61.6% of cases, followed by breast malignancies (12%) and malignant melanoma and diffuse diffuse large B-cell lymphoma (each 6.4%). Specialized inpatient palliative care (SIPC) was provided in 14.8% (10,636 cases), with 85.2% not receiving such care. Hospital mortality was 13.1% (9413 cases), with 42.2% of these involving patients who received SIPC. Discharge outcomes included discharge home (72.7%), transfers to other hospitals (7.1%), rehabilitation facilities (0.4%), nursing facilities (2%), and hospices (2.4%).

Despite treatment advances, high mortality rates for CM patients persist, underscoring the need for palliative care integration and comprehensive training to enhance patient outcomes. Health care planning is a growing topic, our study establishes a benchmark for CM care in German hospitals, revealing a significant number of patients not receiving SIPC. This research can inform future healthcare strategies in neuro-oncology.

The online version contains supplementary material available at 10.1007/s11060-024-04928-4.