Bright Leah, Zink Korie, Klein Eili, Wright Rebecca, Kelen Gabe
Emergency Medicine Department, Johns Hopkins Medical University, Baltimore, MD, United States of America.
Emergency Medicine Department, Johns Hopkins Medical University, Baltimore, MD, United States of America.
Am J Emerg Med. 2022 Jan;51:325-330. doi: 10.1016/j.ajem.2021.11.002. Epub 2021 Nov 8.
Although Emergency Medicine has recognized Palliative Care (PC) as an important aspect of Emergency Medicine, the importance of integrating palliative care into standard practice is underscored by the data that many patients qualify for PC but are not utilizing this part of medicine. We believe Emergency Medicine should integrate Palliative Care as our responsibility and not rely on our colleagues. To support our statement, we undertook an examination of patients who died while inpatient to identify whether they were appropriately receiving palliative care consults. We hypothesized that palliative care is under-utilized for patients during these admissions.
DESIGN, SETTING, AND PARTICIPANT: Retrospective chart review from 2015 to 2018 of inpatient deaths using an Emergency Medicine Palliative Care Screening Tool to determine qualification for Palliative Care. Setting is John Hopkins Hospital. Participants were age 18 and over; who died during their inpatient admission.
Percentage of patients who qualified for palliative care via the screening tool versus percentage of patients who had palliative care involvement.
The final study sample included 428 patients who died inpatient in the hospital between January 2015 and December 2018. The analysis used a Palliative Care Screening Tool to determine which patients would have qualified for palliative care. Analysis demonstrates that 66% of patients qualified for palliative care, whereas only 27% received it.
The data reflects the percentage of patients who qualified for Palliative Care compared to the definite number of patients who received palliative care. The discrepancy in the percentages support our statement Emergency Medicine should take the lead on initiating palliative care for qualifying patients.
尽管急诊医学已将姑息治疗（PC）视为急诊医学的一个重要方面，但许多患者符合姑息治疗条件却未利用这一医疗服务，这些数据凸显了将姑息治疗纳入标准诊疗实践的重要性。我们认为急诊医学应将提供姑息治疗视为自身职责，而非依赖其他科室同事。为支持这一观点，我们对住院期间死亡的患者进行了调查，以确定他们是否得到了适当的姑息治疗会诊。我们推测在这些住院期间，姑息治疗在患者中未得到充分利用。
设计、地点和参与者：采用急诊医学姑息治疗筛查工具，对2015年至2018年住院死亡患者进行回顾性病历审查，以确定是否符合姑息治疗条件。地点为约翰霍普金斯医院。参与者为18岁及以上，在住院期间死亡。
通过筛查工具符合姑息治疗条件的患者百分比与接受姑息治疗的患者百分比。
最终研究样本包括2015年1月至2018年12月期间在该医院住院死亡的428名患者。分析使用姑息治疗筛查工具来确定哪些患者符合姑息治疗条件。分析表明，66%的患者符合姑息治疗条件，而只有27%的患者接受了姑息治疗。
数据反映了符合姑息治疗条件的患者百分比与实际接受姑息治疗的患者确切人数。百分比之间的差异支持了我们的观点，即急诊医学应率先为符合条件的患者启动姑息治疗。
