Lenz K, Hofmann-Bichler B, Pihringer J, Firlinger F, Pickl A, Clodi M
Abteilung für Innere Medizin und Intensivmedizin, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich.
Palliative Care, Konventhospital Barmherzige Brüder Linz, Linz, Österreich.
Med Klin Intensivmed Notfmed. 2017 Nov;112(8):724-730. doi: 10.1007/s00063-017-0261-5. Epub 2017 Feb 1.
We retrospectively analyzed the data of 56 of 669 critically ill patients admitted to an internal medicine intensive care unit (ICU) with palliative care provided by a palliative care team over the period of 12 months. For delivering palliative care, we used a mixed model-consisting of both integrative and consultative elements. SAPS III severity score in patients with palliative care was 63 ± 15 compared to 50 ± 15 in all critically ill patients. Hospital mortality was 62.5 vs. 16%. After 3 months, 19.6% of patients with palliative care provided by the palliative care team were still alive. In 15 patients curative therapies were discontinued, while there was no further escalation of the therapy in 30 patients. In 47 patients, special help to the relatives was offered. In 13 cases, there was a disagreement between relatives and the ICU team; in 5 cases a family conference was implemented. Two patients wanted extensive intensive care therapy, despite unfavorable prognosis; one patient wished to die. One patient had an advanced directive.
我们回顾性分析了在内科重症监护病房（ICU）接受姑息治疗团队为期12个月姑息治疗的669例重症患者中56例的资料。为提供姑息治疗，我们采用了一种混合模式，包括综合和咨询两种要素。接受姑息治疗患者的简化急性生理学评分（SAPS）III严重程度评分为63±15，而所有重症患者的评分为50±15。医院死亡率分别为62.5%和16%。3个月后，接受姑息治疗团队姑息治疗的患者中有19.6%仍存活。15例患者停止了治愈性治疗，30例患者的治疗未进一步升级。47例患者为亲属提供了特殊帮助。13例中，亲属与ICU团队存在分歧；5例进行了家庭会议。2例患者尽管预后不佳仍希望接受广泛的重症监护治疗；1例患者希望死亡。1例患者有预先指示。
