三级护理医院中癌症死亡患者的姑息治疗时机与“不要复苏”医嘱的频率和时机之间的关系
The Relation Between the Timing of Palliative Care and the Frequency and Timing of Do-Not-Resuscitate Orders Among Cancer Deaths in a Tertiary Care Hospital.
作者信息
Alsirafy Samy A, Mohammed Amrallah A, Al-Zahrani Abdullah S, Raheem Ahmad A, El-Kashif Amr T
机构信息
Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine (NEMROCK), Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
Oncology Center, King Abdullah Medical City-Holy Capital, Makkah, Saudi Arabia Medical Oncology Department, Faculty of medicine, Zagazig University, Sharkia, Egypt.
出版信息
Am J Hosp Palliat Care. 2015 Aug;32(5):544-8. doi: 10.1177/1049909114529014. Epub 2014 Mar 26.
The medical records of 246 in-hospital cancer deaths were reviewed to explore the relation between palliative care (PC) timing and the frequency and timing of do-not-resuscitate (DNR) designation. The rate of DNR designation was 100% in patients referred to PC and 82% in those never referred (P < .001). Patients were grouped into 4 groups: early PC (>90 days from PC referral to death), intermediate PC (>30-90 days), late PC (≤30 days), and no PC. The median DNR to death time was 96, 41, 11, and 3 days, respectively (P < .001). The proportion of intensive care unit (ICU) deaths was 0%, 1%, 3%, and 27%, respectively (P < .001). In conclusion, in a tertiary care hospital, earlier PC was associated with earlier DNR designation and less frequent ICU deaths among in-hospital cancer deaths.
回顾了246例住院癌症死亡患者的病历，以探讨姑息治疗（PC）时机与不进行心肺复苏（DNR）医嘱的频率和时机之间的关系。接受PC治疗的患者中DNR医嘱的开具率为100%，未接受PC治疗的患者中这一比例为82%（P <.001）。患者被分为4组：早期PC组（从接受PC治疗到死亡的时间>90天）、中期PC组（>30 - 90天）、晚期PC组（≤30天）和未接受PC组。从开具DNR医嘱到死亡的中位时间分别为96天、41天、11天和3天（P <.001）。重症监护病房（ICU）死亡的比例分别为0%、1%、3%和27%（P <.001）。总之，在一家三级护理医院中，住院癌症死亡患者中，更早的PC治疗与更早开具DNR医嘱以及更低的ICU死亡频率相关。
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