Dhillon Navneet, Kopetz Scott, Pei Be Lian, Fabbro Egidio Del, Zhang Tao, Bruera Eduardo
Department of Palliative Care and Rehabilitation, University of Texas M.D Anderson Cancer Center, Houston, Texas, USA.
J Palliat Med. 2008 Mar;11(2):191-7. doi: 10.1089/jpm.2007.0094.
Palliative care consultation teams (PCCTs) are being established in cancer centers for the management of patients' physical and psychosocial distress. As clinical findings of these teams have been reported infrequently, we aim to describe the experience of our high-volume inpatient PCCT.
We obtained clinical and demographic data on patients referred to our PCCT from the palliative care departmental database from September 1, 2003, to August 31, 2004.
In 1 year, 1067 consultations took place for 922 hospitalized patients. The patients' mean age was 60 (range, 3-98) years. The most common cancers were thoracic/head and neck, gastrointestinal, genitourinary, gynecologic cancers, and lymphoma. Thirty-four percent of the patients were transferred to the inpatient palliative care unit, while the remainder were followed by the PCCT as consultants. The main problems requiring PCCT consultation were pain (56%), delirium (34%), dyspnea (25%), fatigue (14%), and end-of-life psychosocial (EOL) issues (12%). Twenty-four percent of patients died during the hospitalization. Death during the hospitalization was more common in patients with delirium, dyspnea, and EOL issues and less likely in patients referred to the PCCT for pain or depression. Constipation was more common in patients with solid tumors, whereas EOL issues were more common in patients with hematologic malignancies. Of the patients who were able to be discharged, 56% went home, 37% to hospice, and 7% elsewhere.
These results provide insight into the demand and utility of this service for those considering the establishment of a PCCT.
癌症中心正在组建姑息治疗咨询团队（PCCTs），以处理患者的身体和心理社会困扰。由于这些团队的临床发现鲜有报道，我们旨在描述我们这个高容量住院患者PCCT的经验。
我们从姑息治疗部门数据库中获取了2003年9月1日至2004年8月31日转诊至我们PCCT的患者的临床和人口统计学数据。
在1年时间里，为922名住院患者进行了1067次咨询。患者的平均年龄为60岁（范围3 - 98岁）。最常见的癌症类型为胸/头颈癌、胃肠道癌、泌尿生殖系统癌、妇科癌和淋巴瘤。34%的患者被转至住院姑息治疗病房，其余患者则由PCCT作为咨询顾问进行随访。需要PCCT咨询的主要问题包括疼痛（56%）、谵妄（34%）、呼吸困难（25%）、疲劳（14%）和临终心理社会问题（EOL）（12%）。24%的患者在住院期间死亡。住院期间死亡在患有谵妄、呼吸困难和EOL问题的患者中更为常见，而因疼痛或抑郁转诊至PCCT的患者死亡可能性较小。便秘在实体瘤患者中更为常见，而EOL问题在血液系统恶性肿瘤患者中更为常见。在能够出院的患者中，56%回家，37%前往临终关怀机构，7%去往其他地方。
这些结果为那些考虑组建PCCT的人提供了对这项服务的需求和效用的见解。
