• Jonathan T Dullea, Vikram Vasan, Alex Devarajan, Muhammad Ali, Noah Nichols, Danielle Chaluts, Phil Henson, Christian Porras, Christine Lopez, Diego Luna, Lathan Liou, Joshua Bederson, and Raj K Shrivastava.
• Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
• Neurosurgery. 2023 Aug 1; 93 (2): 419426419-426.

BackgroundRecent advances in treatment of malignant brain tumors have improved outcomes. However, patients continue to experience significant disability. Palliative care helps patients with advanced illnesses improve their quality of life. There is a paucity of clinical studies examining palliative care usage among patients with malignant brain tumors.ObjectiveTo assess if there were any patterns in palliative care utilization among patients hospitalized with malignant brain tumors.MethodsA retrospective cohort representing hospitalizations for malignant brain tumors was created from The National Inpatient Sample (2016-2019). Palliative care utilization was identified by ICD-10 code. Univariable and multivariable logistic regression models, accounting for the sample design, were built to evaluate the demographic variables associated with palliative care consultation in all patients and fatal hospitalizations.Results375 010 patients admitted with a malignant brain tumor were included in this study. Over the whole cohort, 15.0% of patients used palliative care. In fatal hospitalizations, Black and Hispanic patients had 28% lower odds of receiving a palliative care consultation compared with White patients (odds ratio for both = 0.72; P = .02). For fatal hospitalizations, patients insured privately were 34% more likely to use palliative care services compared with patients insured with Medicare (odds ratio = 1.34, P = .006).ConclusionPalliative care is underutilized among all patients with malignant brain tumors. Within this population, disparities in utilization are exacerbated by sociodemographic factors. Prospective studies investigating utilization disparities across race and insurance status are necessary to improve access to palliative care services for this population.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.

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