Anesthesia and Intensive Care Unit and Pain Relief and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy.
Department of Oncology, Hospital Sant'Andrea, University of Rome, Rome, Italy.
Support Care Cancer. 2018 Jun;26(6):1961-1966. doi: 10.1007/s00520-017-4037-5. Epub 2018 Jan 8.
A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients.
Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered. The same parameters were recorded at discharge. A follow-up was performed by phone 1 month after discharge.
Two-hundred patients were surveyed. Awareness of disease was more complete in OW patients (P = 0.001). Uncontrolled pain and symptoms were the prevalent reasons for admission to SPCU (P < 0.0005). Toxicity from chemotherapy was more frequently reported by OW patients (P = 0.001). SPCU patients received higher doses of opioids (P = 0.004). More SPCU patients were referred from home and were discharged home (P < 0.0005 and P = 0.018, respectively). Emergency admissions were more frequently reported in OW patients (P < 0.0005). One month after, more SPCU patients were at home and were still on active treatment (P = 0.002, and P = 0.05, respectively). More OW patients died within 1 month (P = 0.001).
SPCU allows a better planning admission to hospital and a better care trajectory in advanced cancer patients in comparison to a busy OW, where unselected emergencies more frequently occur.
支持性姑息治疗病房（SPCU）可能对患者的治疗产生积极影响。本研究旨在比较一组连续的晚期癌症患者中，入组专门的 SPCU 病房和传统肿瘤病房（OW）的患者模式。
收集患者的人口统计学数据、入院原因和类型、照顾者、抗癌治疗、治疗开始/结束/不确定、原发疾病位置、提出住院申请的人员、阿片类药物的使用以及住院情况。在出院时记录相同的参数。在出院后 1 个月通过电话进行随访。
共调查了 200 名患者。OW 病房的患者对疾病的认识更为全面（P = 0.001）。SPCU 病房的主要入院原因是未得到控制的疼痛和症状（P < 0.0005）。OW 病房的患者更多报告化疗毒性（P = 0.001）。SPCU 病房的患者接受了更高剂量的阿片类药物（P = 0.004）。更多 SPCU 病房的患者从家中被转诊而来，出院后也返回家中（P < 0.0005 和 P = 0.018）。OW 病房的患者更多地报告了急诊入院（P < 0.0005）。1 个月后，更多的 SPCU 病房的患者仍在家中并正在接受积极治疗（P = 0.002 和 P = 0.05）。OW 病房的患者在 1 个月内死亡的比例更高（P = 0.001）。
与繁忙的 OW 病房相比，SPCU 能够更好地规划患者入院，为晚期癌症患者提供更好的治疗轨迹，OW 病房中更常发生未经选择的紧急情况。
