TY - JOUR
T1 - Impact of applying palliative care on symptoms and survival of patients with advanced chronic disease admitted to the emergency department
AU - Amado, Jose
AU - Vasquez, Rolando
AU - Huari, Roberto
AU - Rimache, Liliana
AU - Lizonde, Rosa
N1 - Publisher Copyright:
© 2020 Wolters Kluwer Medknow Publications. All rights reserved.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Introduction: In the emergency department, there is a need to provide palliative care; however, they are not usually administered. The present study evaluates the evolution of the intensity of the symptoms when applying palliative care, in adult patients with advanced chronic disease admitted to the emergency room, and compares survival between those who receive this care and those who do not. Materials and Methods: A clinical intervention study was conducted including patients older than 18 years with advanced chronic disease admitted to the emergency room with an indication of palliative support according to the Supportive and Palliative Care Indicators Tool 2015. Three hundred and seven patients were studied (74 in the intervention group and 233 in the group not intervened). In the intervention group, the intensity of pre- and postintervention symptoms was compared (Wilcoxon test). The survival of both the groups were then compared (logrank test). Results: There was a significant decrease in pain and dyspnea at 24 and 48 h postintervention (P < 0.01), respectively, while drowsiness increased significantly at 24 h (P < 0.01) but did not change at 48 h (P = 0.38). Excluding patients with better functional status, there was less survival at 3 months in the intervention group (P = 0.01). Conclusions: Dyspnea and pain decreased with the application of palliative care but not drowsiness. Survival in the intervention group was lower than in the nonintervention group. However, the reason for providing palliative care is to relieve suffering at the end of life.
AB - Introduction: In the emergency department, there is a need to provide palliative care; however, they are not usually administered. The present study evaluates the evolution of the intensity of the symptoms when applying palliative care, in adult patients with advanced chronic disease admitted to the emergency room, and compares survival between those who receive this care and those who do not. Materials and Methods: A clinical intervention study was conducted including patients older than 18 years with advanced chronic disease admitted to the emergency room with an indication of palliative support according to the Supportive and Palliative Care Indicators Tool 2015. Three hundred and seven patients were studied (74 in the intervention group and 233 in the group not intervened). In the intervention group, the intensity of pre- and postintervention symptoms was compared (Wilcoxon test). The survival of both the groups were then compared (logrank test). Results: There was a significant decrease in pain and dyspnea at 24 and 48 h postintervention (P < 0.01), respectively, while drowsiness increased significantly at 24 h (P < 0.01) but did not change at 48 h (P = 0.38). Excluding patients with better functional status, there was less survival at 3 months in the intervention group (P = 0.01). Conclusions: Dyspnea and pain decreased with the application of palliative care but not drowsiness. Survival in the intervention group was lower than in the nonintervention group. However, the reason for providing palliative care is to relieve suffering at the end of life.
KW - Emergency department
KW - palliative care
KW - terminal care
KW - terminally ill
UR - http://www.scopus.com/inward/record.url?scp=85091851417&partnerID=8YFLogxK
U2 - 10.4103/IJPC.IJPC_195_19
DO - 10.4103/IJPC.IJPC_195_19
M3 - Artículo
AN - SCOPUS:85091851417
SN - 0973-1075
VL - 26
SP - 332
EP - 337
JO - Indian Journal of Palliative Care
JF - Indian Journal of Palliative Care
IS - 3
ER -