Reyes-Ortiz Carlos A, Williams Christopher, Westphal Christine
Gerontology Institute, Georgia State University, Atlanta, GA, USA Department of Internal Medicine, Division of Geriatric and Palliative Care, University of Texas Medical School, Houston, TX, USA
Geriatric & Internal Medicine, Oakwood Hospital & Medical Center, Wayne State University, Dearborn, MI, USA.
Am J Hosp Palliat Care. 2015 Aug;32(5):516-20. doi: 10.1177/1049909114530183. Epub 2014 Apr 8.
To examine the effects of early palliative care (PC; EPC; ≤3 days after admission) consultation versus late PC (>3 days) on number of days from day of consult to discharge (DCDAYS), a retrospective review of PC data (2009-2012) included 531 patients with age ≥65 and Palliative Performance Scale ≤50. Early PC was independently associated with lower DCDAYS (P = .019). Persons admitted to hospice (P = .010) as well as those discharged to home (P = .003) and subacute rehabilitation (SAR; P = .015) were more likely to have an EPC compared to those who died. Admitting to hospice was associated with lower DCDAYS than discharging to long-term acute care (P < .001) or SAR (P < .001). Early PC resulted in lower DCDAYS, fewer inpatient deaths, and higher hospice admissions. Hospice resulted in fewer DCDAYS.
为研究早期姑息治疗（PC；EPC；入院后≤3天）会诊与晚期PC（>3天）会诊对从会诊日到出院天数（DCDAYS）的影响，对PC数据（2009 - 2012年）进行回顾性分析，纳入了531例年龄≥65岁且姑息治疗表现量表≤50的患者。早期PC与较短的DCDAYS独立相关（P = 0.019）。与死亡患者相比，入住临终关怀机构的患者（P = 0.010）以及出院回家的患者（P = 0.003）和亚急性康复机构（SAR；P = 0.015）的患者更有可能接受早期PC会诊。与转至长期急性护理机构（P < 0.001）或SAR（P < 0.001）相比，入住临终关怀机构与较短的DCDAYS相关。早期PC导致DCDAYS缩短、住院死亡人数减少以及临终关怀机构入住率提高。临终关怀导致DCDAYS减少。
