Effects of lung transplantation on inpatient end of life care in cystic fibrosis
| Autor: | James R. Yankaskas, Elisabeth P. Dellon, Terry L. Noah, Margaret W. Leigh |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine congenital hereditary and neonatal diseases and abnormalities medicine.medical_specialty Palliative care Adolescent Cystic Fibrosis medicine.medical_treatment Cystic fibrosis Article 03 medical and health sciences 0302 clinical medicine North Carolina medicine Humans Lung transplantation Pediatrics Perinatology and Child Health 030212 general & internal medicine Child Intensive care medicine Retrospective Studies Inpatients business.industry Palliative Care Retrospective cohort study respiratory system medicine.disease respiratory tract diseases 3. Good health surgical procedures operative 030228 respiratory system Pediatrics Perinatology and Child Health Female End of life care business End-of-life care Lung Transplantation |
| Zdroj: | Journal of Cystic Fibrosis. 6:396-402 |
| ISSN: | 1569-1993 |
| Popis: | BackgroundThe impact of lung transplantation on end of life care in cystic fibrosis (CF) has not been widely investigated.MethodsInformation about end of life care was collected from records of all patients who died in our hospital from complications of CF between 1995 and 2005. Transplant and non-transplant patients were compared.ResultsOf 38 patients who died, 20 (53%) had received or were awaiting lung transplantation (“transplant” group), and 18 (47%) were not referred, declined transplant, or were removed from the waiting list (“non-transplant”). Transplant patients were more likely than non-transplant patients to die in the intensive care unit (17 (85%) versus 9 (50%); P=0.04). 16 (80%) transplant patients remained intubated at or shortly before death, versus 7 (39%) non-transplant patients (P=0.02). Do-not-resuscitate orders were written later for transplant patients; 12 (60%) on the day of death versus 5 (28%) in non-transplant patients (P=0.02). Transplant patients were less likely to participate in this decision. Alternatives to hospital death were rarely discussed.ConclusionsReceiving or awaiting lung transplantation affords more aggressive inpatient end of life care. Despite the chronic nature of CF and knowledge of a shortened life span, discussions about terminal care are often delayed until patients themselves are unable to participate. |
| Databáze: | OpenAIRE |
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