临终前一个月的姑息化疗。
Palliative chemotherapy during the last month of life.
机构信息
The Research and Development Unit, Östersund Hospital, Östersund; Department of Radiation Sciences, University of Umeå, Umeå; Department of Nursing, University of Umeå, Umeå.
Department of Nursing, University of Umeå, Umeå; Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm; Research and Development Unit in Palliative Care, Stockholms Sjukhem Foundation, Stockholm, Sweden.
出版信息
Ann Oncol. 2011 Nov;22(11):2375-2380. doi: 10.1093/annonc/mdq778. Epub 2011 Mar 14.
BACKGROUND
This study analyses the potential discriminative characteristics for patients with incurable cancer who received palliative chemotherapy during their last month of life.
PATIENTS AND METHODS
The study includes all patients with epithelial cancer treated with palliative chemotherapy who died in 2008 in northern Sweden. Demographic parameters and care utilization data were registered. Data were analyzed using nonparametric methods.
RESULTS
Of 374 included patients, 87 (23%) received chemotherapy during the last month of life. These patients had a significantly shorter survival time from first palliative treatment to death, were admitted more frequently to hospital, more often lacked a documented decision to cease treatment, and died less frequently at home.
CONCLUSIONS
The results indicate covariations between palliative chemotherapy treatments in the last month of life and unfavorable patient outcomes. As almost one of four patients with incurable cancer received their last round of palliative chemotherapy <31 days before death, there is a potential for improved routines.
背景
本研究分析了在生命的最后一个月接受姑息化疗的不可治愈癌症患者的潜在鉴别特征。
患者和方法
该研究纳入了 2008 年在瑞典北部接受姑息化疗的上皮性癌症患者。记录了人口统计学参数和护理利用数据。使用非参数方法进行数据分析。
结果
在 374 名纳入的患者中，87 名（23%）在生命的最后一个月接受了化疗。这些患者从姑息治疗开始到死亡的生存时间明显更短，住院次数更多，缺乏记录的停止治疗决策的情况更常见，在家中死亡的情况更少见。
结论
结果表明，生命最后一个月的姑息化疗治疗与不良的患者结局之间存在相互关系。由于近四分之一的不可治愈癌症患者在死亡前 31 天内接受了最后一轮姑息化疗，因此有改进常规的潜力。
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