Mount Sinai School of Medicine, New York, New York 10029, USA.
Ann Intern Med. 2010 Mar 2;152(5):296-9. doi: 10.7326/0003-4819-152-5-201003020-00007.
Communication about the deactivation of implantable cardioverter-defibrillators (ICDs) in patients near the end of life is rare.
To determine whether hospices are admitting patients with ICDs, whether such patients are receiving shocks, and how hospices manage ICDs.
Cross-sectional survey.
Randomly selected hospice facilities.
900 hospices, 414 of which responded fully.
Frequency of admission of patients with ICDs, frequency with which patients received shocks, existence of ICD deactivation policies, and frequency of deactivation.
97% of hospices admitted patients with ICDs, and 58% reported that in the past year, a patient had been shocked. Only 10% of hospices had a policy that addressed deactivation. On average, 42% (95% CI, 37% to 48%) of patients with ICDs had the shocking function deactivated.
The study relied on the knowledge of hospice administrators.
Hospices are admitting patients with ICDs, and patients are being shocked at the end of life. Ensuring that hospices have policies in place to address deactivation may improve the care for patients with these devices. The authors provide a sample deactivation policy.
National Institute of Aging and National Institute of Nursing Research.
在生命末期，关于停用植入式心脏复律除颤器（ICD）的沟通很少。
确定临终关怀机构是否收治装有 ICD 的患者，这些患者是否接受电击治疗，以及临终关怀机构如何管理 ICD。
横断面调查。
随机选择的临终关怀机构。
900 家临终关怀机构，其中 414 家机构完整回复。
装有 ICD 的患者入院频率、患者接受电击的频率、ICD 停用政策的存在情况以及停用的频率。
97%的临终关怀机构收治了装有 ICD 的患者，58%的机构报告称，在过去一年中，有患者曾接受电击治疗。只有 10%的临终关怀机构有关于停用的政策。平均而言，42%（95%置信区间，37%至 48%）的装有 ICD 的患者停用了电击功能。
本研究依赖于临终关怀机构管理者的知识。
临终关怀机构正在收治装有 ICD 的患者，且这些患者在生命末期会接受电击治疗。确保临终关怀机构制定了有关停用的政策，可能会改善对这些设备患者的护理。作者提供了一份停用政策示例。
美国国立卫生研究院老龄化研究所和美国国立卫生研究院护理研究所以及国立精神卫生研究所。
