End-of-life care for patients hospitalised in internal medicine departments
Por:
Diez-Manglano, J, Perez, SIDI, Gomez, MR, Formiga, F, Munoz, LAS, Herrero, JC, Vales, EC, Bonafonte, OHT, Perez, MM, Garcia, LFD, Maroto, IV, Losada, CO, Escobar, PG, Perez, CD, Granado, JC, Font, RMG, Lorente, FJJ, Vazquez, GP, Exposito, ABF, Exposito, ABF, Gonzalez, MLA, Antinolo, FG, Molina, AG, Hernandez, MG, Garcia, MG, Leon, LB, Rivas, LM, Mariscal, MR, Aguirre, NG, Garcia, MPG, Algora, IM, Castel, MCB, Laiglesia, FR, Tello, EB, Garcia, JLC, Fernandez, NG, Camera, L, Gauna, C, Requejo, PA, Gutierrez, RM, Regueiro, RF, Vidal, MTS, Mejido, JA, Carus, EG, Rodriguez, CEC, Garcia, PM, Olivares, SR, Barcelo, MIF, Arencibia, CG, Vilamajo, RR, Prieto, MJM, Becerra, CG, Plata, SPAM, Chocarro, RP, Gutierrez, CD, Alvarez, FE, Balbuena, SP, Galindo, RR, Siles, MMC, Lopez, AC, Lobo, CS, Vinas, MMC, Uriel, MAC, Dominguez, JG, Gonzalez, FM, Lazaro, JMM, Gamboa, JM, Galdeano, MR, Gimenez, JC, Farre, JRB, Aragon, RN, Toran, FM, Bare, J, Farre, EG, Minana, AL, Sarabia, DM, Perez, R, Fernandez, DAI, Fernandez, JF, Salomo, AC, Qanneta, R, Ortega, MVP, Diaz, CE, Pintado, YM, Cors, MG, Rivas, MCA, Albin, DD, Morera, JR, Alvaro, NG, Parodi, AT, Sanchez, ML, Acebal, CD, Garcia, JZ, Claveras, LB, Cabanes, JM, Lazaro, IS, Romero, JB, Lopez-Alegria, LN, Lorido, JCA, Vizcaya, AML, Rodriguez, CM, Fernandez, SP, Sanchez, PS, Jimenez-Beatty, MD, Vazquez, LG, Hernando, AB, Anglada, MIG, Lorenzo, VMG, Martin, AP, Melcon, GG, Antunez, MG, Simon, MAQ, Gil, FG, Martinez, MA, Aragoneses, LM, Parra, JC, Perez, MDR, Garcia, JC, Cuesta, FL, Abad, MES, Ortega, MF, Martinez, GL, Blanco, AP, Fraile, RR, Litago, EM, Echeverria, AE, Valladares, MP, Serrano, CT, Mas, JV, Suau, OT, Tomas, EG, Rubio, RC, Zaragoza, JMM, Sanchez, PR, Herola, AG, Doblas, PPT, Encinar, JCB, Vela, EC, Carrizo, N, Galvan, VG, Villanueva, BMR, Liano, FP, Izuel, JMP
Publicada:
1 abr 2019
Resumen:
Objectives: To describe the care provided at the end of life for patients who die in internal medicine departments.
Methods: An observational, cross-sectional, retrospective multicentre, clinical audit study was conducted where each hospital included the first 10 patients who died in the internal medicine department starting on December 1, 2015. We collected demographic and clinical data and information regarding the circumstances and care at the time of death.
Results: The study included 1,447 patients with a median age of 84 years. Of these, 1,065 (74.3%) were polypathological, 751 (51.9%) were terminal and 248 (17.1%) had cancer. For the terminal patients, do-not-resuscitate orders were established for 539 (73.3%), and palliative sedation was performed for 422 (57.4%). There was no record as to whether psychological, religious or grief care was provided in 32%, 64.8% and 44.1% of the terminal patients, respectively. The patients with cancer were more often competent to make decisions (54.4% vs. 15.5%; P<.001), knew their prognosis (42.6% vs. 8.6%; P<.001), received psychological care (24.9% vs. 8.6%; P<.001), died in an individual room (64.6% vs. 44.4%; P<.001) and were accompanied (81.9% vs. 71.9%; P=.003). Their relatives also more frequently received grief care (15.6% vs. 8.2%; P=.002).
Conclusions: There is insufficient recording in the medical history as to the end-of-life care. There are differences in the care provided to patients with cancer and to those without cancer. (C) 2018 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina Interna (SEMI). All rights reserved.
Filiaciones:
Diez-Manglano, J:
Hosp Univ Miguel Servet, Serv Med Interna, Unidad Pacientes Pluripatol, Zaragoza, Spain
Inst Aragones Ciencias Salud, Grp Invest Comorbilidad & Pluripatol Aragon, Zaragoza, Spain
Gomez, MR:
Hosp Univ Miguel Servet, Serv Urgencias, Zaragoza, Spain
Formiga, F:
Hosp Univ Bellvitge, Serv Med Interna, Programa Geriatria, Idibell, Barcelona, Spain
Munoz, LAS:
Hosp Clin Univ, Unidad Pacientes Pluripatol, Serv Med Interna, Valladolid, Spain
Herrero, JC:
Fdn Hosp Calahorra, Unidad Serv Med Interna, Calahorra, La Rioja, Spain
Vales, EC:
Hosp Univ Lucus Augusti, Serv Med Interna, Lugo, Spain
Bonafonte, OHT:
Univ Autonoma Barcelona, Serv Med Interna, Hosp Santa Creu & St Pau, Barcelona, Spain
Perez, MM:
Univ Autonoma Barcelona, Serv Med Interna, Hosp Santa Creu & St Pau, Barcelona, Spain
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