Factores sociodemográficos y clínicos asociados a la derivación de pacientes oncológicos a cuidados paliativos en un hospital de Ecuador.

Abstract

Cancer remains one of the leading causes of mortality in Ecuador, and its management in advanced stages requires the integration of palliative care focused on quality of life. However, referrals to palliative services are often delayed or underutilized. This study aimed to analyze the sociodemographic and clinical factors associated with the referral of oncology patients to palliative care in a specialized hospital in Ecuador. An observational, analytical, and retrospective study was conducted at SOLCA Guayaquil Cancer Center, reviewing medical records of cancer patients who died in 2023. Sociodemographic and clinical variables were collected, and bivariate and multivariate statistical analyses were performed. Findings showed that referral to palliative care was significantly associated with functional status, particularly with the Karnofsky Index (OR: 0.91; 95% CI: 0.87–0.94; p < 0.001). Patients admitted through emergency services had a higher likelihood of referral compared to those hospitalized in other areas (OR range: 0.03–0.11; p < 0.001), while short hospital stays (<5 days) were associated with a lower probability of referral (OR: 0.25; 95% CI: 0.08–0.77; p = 0.015). The results highlight the relevance of structured, functional, and contextual assessments to improve early identification of patients in need of palliative care.