Background: Primary brain cancers (PBC) represent significant morbidity and poor prognosis. Despite evidence from other types of malignancy that early palliative care can improve quality of life and increase survival, compared to other malignancies, patients with PBC are less likely to be linked to palliative care.

Methods: Data from the 2011 Nationwide Inpatient Sample was analyzed using descriptive statistics and multivariable logistic regression to identify factors associated with inpatient palliative care. Data from 2002-2011 was examined to determine trends over time.

Results: Of the 13,266 observed hospitalizations for PBC, 795 (6.0%) had an associated inpatient palliative care consult. Seven hundred seventy-nine (5.9%) were discharged to hospice and 470 (3.6%) died during hospitalization, with 41.9% of these patients receiving palliative care. Of all PBC hospitalizations, 1,909 (14.3%) involved delivery of life-sustaining treatment such as intubation, mechanical ventilation, tracheostomy, percutaneous gastrostomy tube, hemodialysis, or CPR, with 11.0% of these patients receiving inpatient palliative care. In multivariable logistic regression, minority status, male gender, increased age, increased co-morbidities, non-elective admission, history of radiation, and use of life-sustaining therapies were associated with increased odds of palliative care. For PBC, hospital size, location, and teaching status were not significantly associated with palliative care.

Conclusions: While almost half of patients with PBC who are discharged to hospice or who pass away in the hospital receive inpatient palliative care, there appears to be decreased utilization of inpatient palliative care services for patients earlier in the disease course.