Aggressive care at the end of life; Where are we?

Autor: Mohammed, Amrallah, Al-Zahrani, Omar, Salem, Reham, Elsayed, Fifi
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Zdroj: Indian Journal of Palliative Care; Oct-Dec2019, Vol. 25 Issue 4, p539-543, 5p
Abstrakt: Background: Although, efforts to encourage palliative care only for terminal patients, aggressive end-of-life care (EOL) care still common for those probably to die shortly. Aim: Multicenter experiences to investigate where did we stand in this era? Patients and Methods: A retrospective study included patients with advanced solid tumors. The presence of one or more of the following indicators in the last month of life (LM) referred to aggressive EOL care: emergency department (ED) visits ≥ twice, admission to the hospital through ED, death in critical care units (CCUs), and palliative chemotherapy (PC) at the past 2 weeks before death. Results: A total of 435 patients, 51.5% were men with a median age of 62 years (range: 17–108), were included in the study. Most of the patients (89.2%) belonged to Group II; they had attended ED at least twice (60%), approximately 53% admitted to the hospital through ED, 31% received PC-LM with 41% of them had at the past 2 weeks before death, 13% died in the CCUs, and more than half of them (53%) survived <2 weeks. Kaplan–Meier estimator revealed that median survival was 30 days in Group I versus 13 days in Group II (odds ratio: 1.63; 95% confidence interval: 1.20–2.21; P = 0.002). The median survival was statistically significantly associated with PC-LM ≥14 days and the admission mode. There was no statistically significant association with age, sex, and primary cancer sites. Conclusion: The majority of our patients continue with anticancer treatments they possibly do not need and associated with poor survival. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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