Joung Sung Yoon, Lee Chung-Woo, Choi Youn Seon, Kim Seon Mee, Park Seok Won, Mo Eun Shik, Park Jae Hyun, Shin Jean, Lee Hyun Jin, Park Hong Seok
Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea.
Department of Urology, Korea University Guro Hospital, Seoul, Korea.
Korean J Fam Med. 2020 Nov;41(6):392-397. doi: 10.4082/kjfm.19.0077. Epub 2020 May 20.
This study aimed to explore the time interval distribution pattern between the Physicians Order for Life-Sustaining Treatment (POLST) form completion and death at a tertiary hospital in South Korea. It also examined the association between various independent parameters and POLST form completion timing.
A total of 150 critically ill patients admitted to Korea University Guro Hospital between June 1, 2018 and December 31, 2018 who completed the POLST form were retrospectively analyzed and included in this study. Data were analyzed with descriptive statistics, and group comparisons were performed using the chi-square test for categorical variables. Fisher's exact test was also used to compare cancer versus non-cancer groups.
More than half the decedents (54.7%) completed their POLST within 15 days of death and 73.4% within 30 days. The non-cancer group had the highest percentage of patients (77.8%) who died within 15 days of POLST form completion while the colorectal (39.1%) and other cancer (37.5%) groups had the lowest (P=0.336).
Our findings demonstrated a current need for more explicit guidance to assist physicians with initiating more timely, proactive end-of-life discussions.
本研究旨在探讨韩国一家三级医院中医生下达维持生命治疗医嘱（POLST）表格至患者死亡之间的时间间隔分布模式。同时，研究还考察了各种独立参数与POLST表格填写时间之间的关联。
对2018年6月1日至2018年12月31日期间入住韩国大学古罗医院且填写了POLST表格的150例重症患者进行回顾性分析，并纳入本研究。采用描述性统计方法分析数据，对分类变量使用卡方检验进行组间比较。还使用Fisher精确检验比较癌症组与非癌症组。
超过半数的死者（54.7%）在死亡前15天内填写了POLST表格，73.4%在30天内填写。非癌症组在填写POLST表格后15天内死亡的患者比例最高（77.8%），而结直肠癌组（39.1%）和其他癌症组（37.5%）最低（P=0.336）。
我们的研究结果表明，目前需要更明确的指导，以帮助医生更及时、主动地开展临终讨论。
