# Palliative Care Admission at End‐of‐Life in Liver Cancer: A 10 Year Population‐Based Study of 3565 Deaths in Australia

## TL;DR

This study analyzed palliative care use in liver cancer patients in Australia over 10 years, finding that over half received palliative care, with factors like gender, mental health, and hospital admissions influencing its use.

## Contribution

The first Australian population-level study to examine palliative care utilization in liver cancer deaths.

## Key findings

- 55.3% of liver cancer patients had at least one palliative care admission.
- Factors like rural residence, mental health disorders, and hospital admissions increased palliative care use.
- Patients who died in hospital were more likely to receive palliative care compared to others.

## Abstract

Palliative care is essential to manage symptoms and end‐of‐life (EOL) quality, yet its utilisation in liver cancer remains poorly understood. This study examined sociodemographic and clinical characteristics associated with palliative care admission in the last 5 years of life for people with a death from liver cancer.

A population‐based retrospective cohort study of adults (≥ 18 years) who died from liver cancer between 2013 and 2022 in New South Wales, Australia was conducted. Multivariable logistic regression identified factors associated with palliative care admissions using linked hospital, cancer registry, notifiable conditions and mortality records.

There were 3565 deaths and 55.3% of people had at least one palliative care admission. Females (OR 1.25; 95% CI 1.06–1.49), individuals with anxiety‐related disorders (OR 1.63; 95% CI 1.18–2.25), drug‐related dependence (OR 1.81; 95% CI 1.29–2.54), who lived in rural locations (OR 1.39; 95% CI 1.18–1.64), who had metastatic cancer at diagnosis (OR 1.23; 95% CI 1.01–1.50), who had ≥ 4 hospital admissions (OR 1.43; 95% CI 1.08–1.90) or who died in hospital (OR 4.64; 95% CI 4.64–6.52) had a higher likelihood of a palliative care admission compared to no palliative care admissions. People admitted to intensive care (OR 0.60; 95% CI 0.47–0.75) or who had mechanical ventilation (OR 0.46; 95% CI 0.29–0.74) in the last 12 months prior to EOL were less likely to have a palliative care admission.

This is the first Australian study to examine palliative care use in liver cancer on a population‐level. Findings support earlier integration of palliative care to reduce high‐acuity interventions. These insights have implications for service delivery, equity and policy in EOL care planning.