Al-Zahrani Abdullah S, El-Kashif Amr T, Haggag Rasha M, Alsirafy Samy A
Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia.
Am J Hosp Palliat Care. 2013 Feb;30(1):21-4. doi: 10.1177/1049909112437574. Epub 2012 Feb 28.
The medical records of deceased patients were reviewed to describe the pattern of cancer deaths in a newly established Saudi tertiary care hospital. During eleven months, 87 patients died of cancer. The majority (80 patients, 92%) died of incurable cancer; among which 53% did not receive any systemic anti-cancer therapy (SAT) and 43% received SAT with palliative intent. Younger age (< 65 years), relatively chemosensitive tumours and initial presentation in a potentially curable stage were associated with higher prevalence of palliative SAT administration (p = 0.009, 0.019 and 0.001, respectively). The last palliative SAT was administered during the last two months of life in 66% and during the last two weeks in 14%. During the last admission, 54% of patients were admitted through emergency room, 50% stayed >14 days and 14% died in intensive care unit or emergency room. The results demonstrate that palliative care is a realistic treatment for the majority of patients in our setting and that a significant proportion of these patients receive aggressive care at the end-of-life. There is a need to establish an integrative palliative care program to improve the quality-of-life of dying cancer patients in our region and to minimize the aggressiveness of end-of-life care.
回顾已故患者的病历,以描述一家新建的沙特三级护理医院的癌症死亡模式。在11个月期间,87名患者死于癌症。大多数(80名患者,92%)死于无法治愈的癌症;其中53%未接受任何全身抗癌治疗(SAT),43%接受了姑息性SAT治疗。较年轻(<65岁)、相对化疗敏感的肿瘤以及在潜在可治愈阶段的初始表现与姑息性SAT给药的较高患病率相关(分别为p = 0.009、0.019和0.001)。66%的患者在生命的最后两个月接受了最后一次姑息性SAT治疗,14%在最后两周接受了治疗。在最后一次住院期间,54%的患者通过急诊室入院,50%的患者住院时间超过14天,14%的患者在重症监护室或急诊室死亡。结果表明,姑息治疗对我们环境中的大多数患者来说是一种切实可行的治疗方法,并且这些患者中有很大一部分在生命末期接受了积极的治疗。有必要建立一个综合姑息治疗项目,以提高我们地区临终癌症患者的生活质量,并尽量减少临终治疗的激进程度。