Department of Palliative Care, University of Muenster, 48149 Muenster, Germany.
Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, 52074 Aachen, Germany.
Int J Environ Res Public Health. 2020 Jul 10;17(14):4977. doi: 10.3390/ijerph17144977.
: Acute health service requires focused palliative care (PC). This study was performed to provide guidance for the establishment of a palliative care consultation service (PCCS). : This study was conceived as a retrospective single-center study for observing, analyzing and evaluating the initial setup of a PCCS from 1 May 2015 to 31 May 2018. Patients from Muenster University Hospital with advanced life-limiting diseases, identified to require PC, were included. : PCCS was requested from various departments, for between 20 and 80 patients per month, corresponding to a total of 2359 for the study period. Requests were highest in internal medicine (27.3%), gynecology (18.1%) and radiotherapy (17.6%). Time to referral was significantly shorter in departments with special PCCS ward rounds (6 ± 9 vs. 12 ± 22 days, < 0.001). The most frequently reported symptoms were fatigue, pain and loss of appetite. Pain was frequently localized in the stomach (20.4%), back (17.1%), or in the head and neck area (14.9%). After the first PCCS consultation, 254 patients (90%) reported sufficient pain relief after 48 h. An introduction/modification of painkiller medication, which was recommended for 142 inpatients, was implemented in 57.0% of cases by the respective departments. Overall, the direct realization of PCCS recommendations reached only 50% on average. : Besides an analysis of the ability to address the symptoms of the referred patients by the PCCS, this study highlights the importance of the interaction between PCCS and other departments. It further elucidates the role and possibilities of this service both in regular ward rounds and individual staff contacts.
急性医疗服务需要集中的姑息治疗（PC）。本研究旨在为建立姑息治疗咨询服务（PCCS）提供指导。
本研究是一项回顾性单中心研究，旨在观察、分析和评估 2015 年 5 月 1 日至 2018 年 5 月 31 日期间 PCCS 的初步建立情况。研究纳入了来自明斯特大学医院的患有晚期生命有限疾病、需要 PC 的患者。
PCCS 由各个科室提出需求，每月 20 至 80 例不等，研究期间共 2359 例。内科（27.3%）、妇科（18.1%）和放疗科（17.6%）的需求最高。在有特殊 PCCS 查房的科室，转介时间明显缩短（6±9 天比 12±22 天，<0.001）。报告最多的症状是疲劳、疼痛和食欲不振。疼痛常位于胃部（20.4%）、背部（17.1%）或头颈部（14.9%）。首次 PCCS 咨询后，254 例（90%）患者报告 48 小时后疼痛缓解充分。建议 142 例住院患者调整/修改止痛药，其中 57.0%的病例由相关科室实施。总体而言，PCCS 建议的直接实施率平均仅为 50%。
除了分析 PCCS 对转介患者症状的处理能力外，本研究还强调了 PCCS 与其他科室之间相互作用的重要性。它进一步阐明了该服务在常规查房和个别员工联系中的作用和可能性。
