Palliative Care, 71545Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
7938University of Toronto, Toronto, Ontario, Canada.
J Palliat Care. 2021 Apr;36(2):135-139. doi: 10.1177/0825859719869062. Epub 2019 Aug 23.
Emergency department visits or readmission to hospital are common particularly among those with advanced illness. Little prospective data exist on early outcomes specifically for patients seen by a palliative care consult service during their acute care admission, who are subsequently discharged home.
This study followed 62 oncology patients who had had a palliative care consult during their admission to acute care with weekly phone calls postdischarge for 4 weeks. Events recorded included death, readmission, emergency department visits, and admission to a palliative care unit.
By the end of the study, 32 (52%) of 62 had had at least 1 event, (readmission, emergency department visit, or death), with the majority of these occurring in the first 2 weeks postdischarge. The overall 4-week death rate was 14 (22.6%) of 62.
These data suggest that the need for a palliative care consult identifies inpatients at very high risk for early deterioration and underlines the critical importance of advance care planning/goals-of-care discussions by the oncology and palliative care teams to ensure patients and families understand their disease process and have the opportunity to direct their care decisions.
急诊就诊或再次住院在晚期疾病患者中很常见。在急性住院期间接受姑息治疗咨询服务并随后出院回家的患者，其早期预后的前瞻性数据很少。
本研究对 62 名在急性住院期间接受姑息治疗咨询的肿瘤患者进行了随访，在出院后每周进行 4 周的电话随访。记录的事件包括死亡、再次入院、急诊就诊和入住姑息治疗病房。
在研究结束时，62 名患者中有 32 名（52%）至少发生了 1 次事件（再次入院、急诊就诊或死亡），其中大多数发生在出院后 2 周内。62 名患者的 4 周总死亡率为 14 名（22.6%）。
这些数据表明，姑息治疗咨询的需求可以识别出极有可能在早期恶化的住院患者，并强调肿瘤学和姑息治疗团队进行预先护理计划/目标护理讨论的重要性，以确保患者和家属了解他们的疾病过程并有机会指导他们的护理决策。
