[死于医院的终末期非肿瘤性疾病：一项决策分析]
[Dying in the hospital from an end-stage non-oncologic disease: a decision making analysis].
作者信息
Formiga Francesc, Vivanco Victoria, Cuapio Yazz, Porta Josep, Gómez-Batiste Xavier, Pujol Ramón
机构信息
UFISS de Geriatría. Servicio de Medicina Interna. Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat. Barcelona, Spain.
出版信息
Med Clin (Barc). 2003 Jun 21;121(3):95-7. doi: 10.1016/s0025-7753(03)73867-6.
BACKGROUND AND OBJECTIVE
The aim of the study was to evaluate palliative decision-making in non- oncological patients who died in an acute care hospital.
PATIENTS AND METHOD
293 patients > 64 years old were analyzed. These patients suffered from dementia (46%), end-stage congestive heart failure (31%) and end-stage chronic obstructive pulmonary disease (23%). We evaluated written information about: do not resuscitate (DNR) orders, graduation of therapeutic decisions, information provided to relatives about prognosis, total withdrawal of other drug therapy and provision of terminal care.
RESULTS
DNR orders were specified in 37% of cases, graduation of therapeutic decisions in 18% and knowledge of the prognosis by relatives in 57%. Drug withdrawal was carried out in 56% and palliative care in 65% patients.
CONCLUSIONS
Identification and provision of palliative care, in an acute care hospital, of elderly patients at their last admission prior to death because of non-oncological end-stage diseases must be improved.
背景与目的
本研究旨在评估在急性护理医院死亡的非肿瘤患者的姑息治疗决策情况。
患者与方法
对293名64岁以上患者进行了分析。这些患者患有痴呆症（46%）、终末期充血性心力衰竭（31%）和终末期慢性阻塞性肺疾病（23%）。我们评估了以下方面的书面信息：不进行心肺复苏（DNR）医嘱、治疗决策分级、向亲属提供的预后信息、完全停止其他药物治疗以及提供临终关怀。
结果
37%的病例明确了DNR医嘱，18%进行了治疗决策分级，57%的亲属了解预后情况。56%的患者停止了药物治疗，65%的患者接受了姑息治疗。
结论
对于因非肿瘤终末期疾病在急性护理医院最后一次入院前死亡的老年患者，必须改善其姑息治疗的识别与提供情况。
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