To describe aggressive treatments at end-of-life among inpatients with cancer and non-cancer diseases and to evaluate factors associated with these treatments using the Japanese national database (NDB). We conducted a retrospective cohort study among inpatients aged ≥ 20 years who died between 2012 and 2015 using a sampling dataset of NDB. The outcome was the proportion of aggressive treatments in the last 14 days of life. We considered the underlying causes of death as cancer, dementia/senility, and heart, cerebrovascular, renal, liver, respiratory, and neurodegenerative diseases. We analyzed 54,105 inpatients, with underlying cause of death distributed as follows: cancer, 24.9%; heart disease, 16.5%; respiratory disease, 12.3%; and cerebrovascular disease, 9.7%. The proportion of intensive care unit (ICU) admission was 9.7%, being the highest in heart disease (20.5%), followed by cerebrovascular diseases (12.6%), and least in dementia/senility (.6%). The proportion of cardiopulmonary resuscitation was 19.6%, being the highest in heart disease (38.1%), followed by renal diseases (19.5%), and least in cancer (6.2%). Multivariate logistic regression analysis revealed that having heart diseases, cerebrovascular diseases, younger age, less comorbidities, and shorter length of stay were associated with an increasing risk of aggressive treatments in the last 14 days of life. The proportion of aggressive treatments at the end-of-life varies depending on the disease; additionally, these treatments were associated with having heart diseases, younger age, less comorbidity, and shorter length of stay. Our findings may help develop and set benchmarks for quality indicators at the end-of-life for patients with non-cancer diseases.

中文翻译：

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使用日本国家索赔数据库对癌症和非癌症疾病住院患者进行积极的临终治疗。

描述癌症和非癌症疾病住院患者临终时的积极治疗，并使用日本国家数据库 (NDB) 评估与这些治疗相关的因素。我们使用 NDB 抽样数据集，对 2012 年至 2015 年间死亡的 20 岁以上住院患者进行了回顾性队列研究。结果是生命最后 14 天内积极治疗的比例。我们认为死亡的根本原因是癌症、痴呆/衰老以及心脏、脑血管、肾脏、肝脏、呼吸系统和神经退行性疾病。我们分析了 54,105 名住院患者，其根本死因分布如下：癌症，24.9%；心脏病，16.5%；呼吸道疾病，12.3%；脑血管疾病占9.7%。入住重症监护病房（ICU）的比例为9.7%，其中心脏病患者最高（20.5%），其次是脑血管疾病（12.6%），痴呆/衰老最少（0.6%）。心肺复苏比例为19.6%，其中心脏病最高（38.1%），其次为肾病（19.5%），最低为癌症（6.2%）。多变量逻辑回归分析显示，患有心脏病、脑血管疾病、年龄较小、合并症较少和住院时间较短与生命最后14天内积极治疗的风险增加相关。临终时积极治疗的比例因疾病而异；此外，这些治疗与患有心脏病、年龄较小、合并症较少和住院时间较短有关。我们的研究结果可能有助于为非癌症疾病患者临终时的质量指标制定和设定基准。