Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.
Stockholm and R & D Department, Stockholms Sjukhem Foundation, Stockholm, Sweden.
J Palliat Med. 2021 Jul;24(7):1067-1071. doi: 10.1089/jpm.2020.0688. Epub 2021 Mar 5.
To compare symptom prevalence and relief in residents who died in nursing homes with residents who were acutely referred to hospitals. Data on symptoms during the last week of life from the Swedish Register of Palliative Care (SRPC). Nursing homes ( = 1903 deaths) and hospitals in Sweden ( = 202 nursing home residents who were admitted to hospital before death). Data were retrieved on August 24, 2020. Residents who died in hospitals had more breakthrough symptoms of breathlessness (60% vs. 31%, < 0.0001) and delirium (41% vs. 25%, < 0.0001) than those who died in nursing homes. When symptoms were present, complete symptom relief was seen less often in hospitals compared with nursing homes (breathlessness, 28% vs. 47%, < 0.001; delirium, 10% vs. 35%, < 0.0001; respiratory secretions, 30% vs. 55%, < 0.0001). Despite access to oxygen and pharmacologic/nonpharmacologic therapies in hospitals, symptom relief in dying nursing home residents acutely admitted to hospitals was lower compared with those who died in nursing homes, possibly because of differences in patient characteristics.
比较在养老院去世的居民和急性转诊到医院的居民的症状发生率和缓解情况。从瑞典姑息治疗登记处（SRPC）获得生命最后一周的症状数据。瑞典的养老院（ = 1903 例死亡）和医院（ = 202 例养老院居民在死亡前被收治入院）。数据于 2020 年 8 月 24 日检索。与在养老院去世的居民相比，在医院去世的居民有更多的呼吸急促（60%对 31%， < 0.0001）和谵妄（41%对 25%， < 0.0001）的突破性症状。当出现症状时，与养老院相比，医院的完全症状缓解较少见（呼吸急促，28%对 47%， < 0.001；谵妄，10%对 35%， < 0.0001；呼吸道分泌物，30%对 55%， < 0.0001）。尽管在医院可以使用氧气和药物/非药物疗法，但与在养老院去世的居民相比，急性转诊到医院的临终养老院居民的症状缓解率较低，这可能是因为患者特征存在差异。
