Ferri-Dessens R M, Thomas P, Barlesi F, Raholimina V, Kleisbauer J P
Département des Maladies Respiratoires, Service d'Oncologie Respiratoire, Hôpital Sainte-Marguerite, F 13009 Marseille.
Rev Mal Respir. 2001 Feb;18(1):35-9.
The purpose of this study was to determine whether good-quality care for patients with lung cancer can be delivered without a full hospitalization unit. Our study included all consecutive untreated lung cancer patients admitted over a two-year period. The following criteria were analyzed retrospectively: residence, age, sex, histology, staging, treatments, administrative data during the first 6 months of treatment, place of death, and duration of last stay before death in the unit. Two hundred six patients were recorded. Twenty-eight percent of the patients had stage IIIB disease and 61% stage IV disease. The first treatment included: surgery (12%), chemotherapy (80%). During the first six months, the median number of hospitalizations was 8 and the median number of full hospitalization days was 17 compared with 6 days for one-day stays. The median duration of the first stay was 5 days whereas the duration of the last one was 3 days. During the first year, 71% of the patients dies: 36% in our unit (47% of them were inpatients for more than 6 days during their last stay). Diagnosis, initial treatment, management of treatment complications and supportive care are not compatible with weekly hospitalization. Full hospitalization is mandatory for good-quality care in a referral cancer unit.
本研究的目的是确定在没有完整住院单元的情况下,能否为肺癌患者提供高质量的护理。我们的研究纳入了在两年期间收治的所有连续未接受治疗的肺癌患者。对以下标准进行了回顾性分析:居住地、年龄、性别、组织学类型、分期、治疗方法、治疗前6个月的管理数据、死亡地点以及在该单元死亡前的最后住院时间。记录了206例患者。28%的患者患有ⅢB期疾病,61%患有Ⅳ期疾病。首次治疗包括:手术(12%)、化疗(80%)。在最初的六个月里,住院次数的中位数为8次,完整住院天数的中位数为17天,而一日住院的天数中位数为6天。首次住院的持续时间中位数为5天,而最后一次住院的持续时间为3天。在第一年,71%的患者死亡:36%在我们的单元死亡(其中47%在最后一次住院期间住院超过6天)。诊断、初始治疗、治疗并发症的管理和支持性护理与每周住院不兼容。在转诊癌症单元,完整住院对于提供高质量护理是必不可少的。