Mehta Ankita, Chai Emily, Berglund Keisha, Rizzo Elizabeth, Moreno Jaison, Gelfman Laura P
Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Social Work Services, Mount Sinai Hospital, New York, New York, USA.
J Palliat Med. 2021 Jun;24(6):910-913. doi: 10.1089/jpm.2020.0543. Epub 2021 Feb 1.
To examine the relationship between admission Karnofsky Performance Status (KPS) and discharge disposition. Little is known about the relationship between functional status before hospitalization and discharge disposition. In a retrospective cohort study of patients seen by Mount Sinai Hospital Medicine Primary Palliative Care Program (HPPC), we used demographic and clinical data to compare discharge disposition by patients' functional status before admission into the hospital. Overall, 596 patients received HPPC consults (286 [48%] female, mean age 68.4 years, median admission KPS 40% [requires hospital level care]). Of the 33 patients with a KPS ≥60% (unable to work) 30 (91%) were discharged home, whereas those 262 patients with KPS ≤30% (severely disabled) 52 (20%) were discharged home, 40 (15%) enrolled in hospice, 130 (49.5%) discharged to a facility, and 32 (12%) died in hospital. Worse functional status was associated with a hospice or facility discharge and better functional status was associated with discharge home. This retrospective cohort study examined the relationship between KPS before hospital admission and discharge disposition in hospitalized seriously ill patients admitted to the hospital medicine service who received a HPPC consultation. The results suggest that those with a higher admission KPS (more functional) are more likely to be discharged home, whereas those with a lower KPS (less functional) are more likely to be discharged to a facility or hospice. KPS before hospital admission could guide palliative care resource allocation and discharge needs.
探讨入院时卡氏功能状态评分（KPS）与出院处置之间的关系。关于住院前功能状态与出院处置之间的关系，目前所知甚少。在一项针对西奈山医院医学初级姑息治疗项目（HPPC）所诊治患者的回顾性队列研究中，我们利用人口统计学和临床数据，根据患者入院前的功能状态比较出院处置情况。总体而言，596例患者接受了HPPC会诊（286例[48%]为女性，平均年龄68.4岁，入院时KPS中位数为40%[需要医院级护理]）。在KPS≥60%（无法工作）的33例患者中，30例（91%）出院回家；而在KPS≤30%（严重残疾）的262例患者中，52例（20%）出院回家，40例（15%）登记接受临终关怀，130例（49.5%）转至机构，32例（12%）在医院死亡。功能状态较差与出院至临终关怀机构或机构有关，功能状态较好与出院回家有关。这项回顾性队列研究探讨了入院前KPS与接受HPPC会诊的住院重症患者出院处置之间的关系。结果表明，入院时KPS较高（功能较好）的患者更有可能出院回家，而KPS较低（功能较差）的患者更有可能转至机构或临终关怀机构。入院前的KPS可指导姑息治疗资源分配和出院需求。
