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新冠疫情对西班牙癌症患者姑息治疗的影响

Impact of the COVID-19 Pandemic on Palliative Care in Cancer Patients in Spain.

作者信息

Beltran-Aroca Cristina M, Ruiz-Montero Rafael, Llergo-Muñoz Antonio, Rubio Leticia, Girela-López Eloy

机构信息

Section of Legal and Forensic Medicine, Facultad de Medicina y Enfermería, Universidad de Córdoba, 14004 Córdoba, Spain.

Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Avenida Menéndez Pidal s/n, 14004 Córdoba, Spain.

出版信息

Int J Environ Res Public Health. 2021 Nov 15;18(22):11992. doi: 10.3390/ijerph182211992.

Abstract

BACKGROUND

The COVID-19 pandemic outbreak has severely affected healthcare organizations worldwide, and the provision of palliative care (PC) to cancer patients has been no exception. The aim of this paper was to analyse the levels of health care provided by the Clinical Management Unit for PC in Córdoba (Spain) for cancer patients.

METHOD

a retrospective cohort study was conducted. It analyzed the PC internal management database including all cancer patients treated in the period of 2018-2021.

RESULTS

1967 cases were studied. There was a drop in cancer cases ( = 0.008), deaths at the PC hospital ( < 0.001), and referrals from primary care ( < 0.001). However, there was a rise in highly complex clinical situations ( = 0.020) and in ECOG performance status scores of 3-4 ( < 0.001). The pandemic was not shown to be a risk factor for survival in the PC program (0.99 [0.82-1.20]; = 0.931). However, being female ( = 0.005), being older and having a high Karnofsky Performance Status (KPS) score ( < 0.001) could be indicators of a longer stay.

CONCLUSION

The COVID-19 pandemic has presented a challenge in the management of patients requiring PC and has highlighted the urgent needs of the healthcare system if it is to continue providing a level of care which meets the needs of patients and their families.

摘要

背景

新冠疫情的爆发严重影响了全球的医疗机构,为癌症患者提供姑息治疗也不例外。本文旨在分析西班牙科尔多瓦姑息治疗临床管理单元为癌症患者提供的医疗服务水平。

方法

进行了一项回顾性队列研究。分析了姑息治疗内部管理数据库,其中包括2018年至2021年期间接受治疗的所有癌症患者。

结果

共研究了1967例病例。癌症病例数有所下降(=0.008),姑息治疗医院的死亡人数下降(<0.001),初级保健机构的转诊人数下降(<0.001)。然而,高度复杂的临床情况有所增加(=0.020),东部肿瘤协作组(ECOG)体能状态评分为3 - 4分的情况增加(<0.001)。在姑息治疗项目中,疫情未被证明是生存的危险因素(0.99[0.82 - 1.20];=0.931)。然而,女性(=0.005)、年龄较大以及卡诺夫斯基功能状态(KPS)评分较高(<0.001)可能是住院时间较长的指标。

结论

新冠疫情给需要姑息治疗的患者管理带来了挑战,并凸显了医疗系统若要继续提供满足患者及其家属需求的医疗服务水平的迫切需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cae/8618945/ca6bef3ea4ca/ijerph-18-11992-g001.jpg

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