Hsu Nin-Chieh, Lin Yu-Feng, Shu Chin-Chung, Yang Ming-Chin, Ko Wen-Je
Division of Hospital Medicine, Department of Traumatology, National Taiwan University Hospital, Taipei, Taiwan.
Am J Hosp Palliat Care. 2013 Jun;30(4):334-8. doi: 10.1177/1049909112449068. Epub 2012 Jun 5.
Little is known about the picture of patients receiving palliative care in the acute care setting. The study was conducted in a medical center in Taiwan. Cancer palliative care (CPC) was performed for terminal do-not-resuscitate (DNR) patients with advanced cancers. Noncancer palliative care (NCPC) was performed for DNR patients who did not fulfill the criteria of CPC. Of the 1379 consecutive admissions, 258 patients were identified, with 193 (74.8%) requiring NCPC and 65 (25.2%) requiring CPC. The NCPC patients were older and had lower Charlson comorbidity index (2.6 vs 8.6, P < .001) than CPC patients and had poorer consciousness and more organ failure than CPC patients when recognized. Many noncancer patients without access to specialist palliative care services were treated in the acute care setting with delayed recognition.
对于在急性护理环境中接受姑息治疗的患者情况知之甚少。该研究在台湾的一家医疗中心进行。对患有晚期癌症的末期不进行心肺复苏(DNR)患者实施癌症姑息治疗(CPC)。对不符合CPC标准的DNR患者实施非癌症姑息治疗(NCPC)。在连续的1379例入院患者中,确定了258例患者,其中193例(74.8%)需要NCPC,65例(25.2%)需要CPC。NCPC患者比CPC患者年龄更大,Charlson合并症指数更低(2.6对8.6,P <.001),并且在确诊时意识更差,器官衰竭更多。许多无法获得专科姑息治疗服务的非癌症患者在急性护理环境中接受治疗,且诊断延迟。