Referrals to a perinatal specialist palliative care consult service in Ireland, 2012-2015
| Autor: | Maeve O’Reilly, Des L McMahon, Mary Devins, Marie Twomey |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Pediatrics Palliative care Referral Heart disease Asymptomatic 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics medicine Humans 030212 general & internal medicine Neonatology Medical diagnosis Referral and Consultation Retrospective Studies business.industry Palliative Care Obstetrics and Gynecology Retrospective cohort study General Medicine medicine.disease Perinatal Care Pediatrics Perinatology and Child Health Emergency medicine Female medicine.symptom business Ireland |
| Zdroj: | Archives of disease in childhood. Fetal and neonatal edition. 103(6) |
| ISSN: | 1468-2052 |
| Popis: | ObjectiveTo analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile.DesignA retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015.SettingA consultant-led paediatric SPCS at Our Lady’s Children’s Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin.Results83 perinatal referrals were received in a 4-year period. Chromosomal abnormalities accounted for 35% of diagnoses, congenital heart disease 25%, complex neurological abnormalities 11% and renal agenesis 4%. 22 referrals (26.5%) were made antenatally, with 61 (73.5%) postnatally. Of the postnatal referrals, 27 (44%) were asymptomatic on referral. An opioid medication was recommended (regularly or as required) in 46 cases. Symptom control was achieved without dose titration in 43 of these cases (93%). Of 47 deaths in this group referred postnatally, 22 of these (47%) died at home with support from community teams. Discharge home for best supportive care required complex interagency communication and cooperation.ConclusionsPerinatal palliative care requires effective multidisciplinary work, whether delivered in the inpatient setting or in the community. With appropriate support, end-of-life care can be delivered in the community. |
| Databáze: | OpenAIRE |
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