Factors associated with discharge disposition on an acute palliative care unit
| Autor: | Gary Rodin, Camilla Zimmermann, David Hausner, Ashley Pope, Jenny Lau, Breffni Hannon, John Bryson, Lisa W. Le, Nanor Kevork |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Patient Transfer medicine.medical_specialty Palliative care Critical Care Symptom assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Neoplasms Symptom Cluster Terminal care Medicine Humans 030212 general & internal medicine Returned home Aged Retrospective Studies Aged 80 and over Terminal Care business.industry Palliative Care Discharge disposition Cancer Middle Aged medicine.disease Prognosis Patient Discharge 3. Good health Hospitalization Hospice Care Oncology 030220 oncology & carcinogenesis Delirium Female medicine.symptom business Hospital Units |
| Zdroj: | Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. 26(11) |
| ISSN: | 1433-7339 |
| Popis: | Acute palliative care units (APCUs) admit patients with cancer for symptom control, transition to community palliative care units or hospice (CPCU/H), or end-of-life care. Prognostication early in the course of admission is crucial for decision-making. We retrospectively evaluated factors associated with patients’ discharge disposition on an APCU in a cancer center. We evaluated demographic, administrative, and clinical data for all patients admitted to the APCU in 2015. Clinical data included cancer diagnosis, delirium screening, and Edmonton Symptom Assessment System (ESAS) symptoms. An ESAS sub-score composed of fatigue, drowsiness, shortness of breath, and appetite (FDSA) was also investigated. Factors associated with patients’ discharge disposition (home, CPCU/H, died on APCU) were identified using three-level multinomial logistic regression. Among 280 patients, the median age was 65.5 and median length of stay was 10 days; 155 (55.4%) were admitted for symptom control, 65 (23.2%) for transition to CPCU/H, and 60 (21.4%) for terminal care. Discharge dispositions were as follows: 156 (55.7%) died, 63 (22.5%) returned home, and 61 (21.8%) were transferred to CPCU/H. On multivariable analysis, patients who died were less likely to be older (OR 0.97, p = 0.01), or to be admitted for symptom control (OR 0.06, p |
| Databáze: | OpenAIRE |
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