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生命终末期 6 个月内居家天数:血液病患者终末期照护质量指标

Days spent at home in the last 6 months of life: a quality indicator of end of life care in patients with hematologic malignancies.

机构信息

Division of Hematology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.

Department of Medicine, University of Toronto, Toronto, Canada.

出版信息

Leuk Lymphoma. 2020 Jan;61(1):146-155. doi: 10.1080/10428194.2019.1654095. Epub 2019 Aug 22.

Abstract

Despite advances in the management of hematologic malignancies, a significant proportion of patients die of their disease. We used administrative databases in Ontario, Canada (between 2005 and 2013) to determine the number of days spent at home in the last 6 months of life. We studied the predictors of the median number of days at home (DAH) using quantile regression. For the 11,127 patients with hematologic malignancies who died, the median number of DAH in the last 6 months was 156 days. Patients with acute leukemias ( < .0001), women ( < .0001), and those requiring transfusions ( < .0001) spent the fewest DAH. Patients assessed by palliative care prior to their last 6 months were likely to spend more time at home ( < .0001). Providing additional supports for patients nearing the end of life, including earlier access to palliative care and continued transfusion support, may increase the likelihood that patients can die at home.

摘要

尽管在血液系统恶性肿瘤的治疗方面取得了进展,但仍有相当一部分患者死于该疾病。我们使用了加拿大安大略省的行政数据库(2005 年至 2013 年),以确定在生命的最后 6 个月中在家中度过的天数。我们使用分位数回归来研究中位数在家天数(DAH)的预测因素。对于 11127 名死于血液系统恶性肿瘤的患者,最后 6 个月的中位数 DAH 为 156 天。患有急性白血病的患者(<0.0001)、女性(<0.0001)和需要输血的患者(<0.0001)在家中度过的时间最短。在生命的最后 6 个月之前接受姑息治疗评估的患者更有可能在家中度过更多时间(<0.0001)。为接近生命终点的患者提供更多支持,包括更早获得姑息治疗和持续输血支持,可能会增加患者在家中死亡的可能性。

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