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癌症患者的姑息治疗:新冠疫情如何影响护理质量。

Palliative care to cancer patients: how COVID-19 pandemic could affect quality of care.

作者信息

Todaro Juliana, Nogueira Camila Viale, Conte Elisa Rossi, Kaliks Rafael Aliosha

机构信息

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2022 May 27;20:eAO6459. doi: 10.31744/einstein_journal/2022AO6459. eCollection 2022.

Abstract

OBJECTIVE

To evaluate the impact of COVID-19 pandemic on the care delivered to hospitalized cancer patients in end-of-life.

METHODS

A retrospective analysis of data of hospitalized patients with advanced solid tumors, who died under exclusive palliative care during first wave (March 2020 to July 2020) compared with the period previous pandemic (January 2018 to February 2020).

RESULTS

A total of 190 oncologic patients were included, 161 patients before the pandemic, and 29 in the period from March 2020 to July 2020. The average hospitalization was 497.2 patients per month, before the pandemic, and dropped to an average of 46.5 in the pandemic, whereas the death rate decreased from an average of 6.3 patients per month to 4.8. Considering the benchmarks for quality of care during end-of-life care, preferences on life assistance were discussed prior to hospitalization for 34.4%, before the pandemic, and 13.8% during the pandemic (p=0.0298); 9.3% received chemotherapy 15 days prior to the date of death, before the pandemic, and 20.7%, in the pandemic (p=0.1012).

CONCLUSION

Based on the present results, despite the decrease in oncology admissions, the advanced-stage cancer patients continued to seek hospital for end-of-life care. However, we could observe in our benchmarking analyses for palliative quality of care that talks about prognosis occurred less often during the pandemic.

摘要

目的

评估2019冠状病毒病(COVID-19)大流行对临终住院癌症患者护理的影响。

方法

对晚期实体瘤住院患者的数据进行回顾性分析,将第一波疫情期间(2020年3月至2020年7月)在单纯姑息治疗下死亡的患者与大流行前时期(2018年1月至2020年2月)进行比较。

结果

共纳入190例肿瘤患者,大流行前161例,2020年3月至7月期间29例。大流行前平均每月住院497.2例患者,大流行期间降至平均46.5例,而死亡率从平均每月6.3例降至4.8例。考虑到临终护理期间的护理质量基准,大流行前34.4%的患者在住院前讨论了生命援助偏好,大流行期间为13.8%(p=0.0298);大流行前9.3%的患者在死亡前15天接受化疗,大流行期间为20.7%(p=0.1012)。

结论

根据目前的结果,尽管肿瘤住院人数减少,但晚期癌症患者仍继续前往医院接受临终护理。然而,在我们对姑息治疗质量的基准分析中,我们可以观察到在大流行期间关于预后的讨论较少发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/622c/9126599/894bf415db30/2317-6385-eins-20-eAO6459-gf01.jpg

相似文献

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Palliative care to cancer patients: how COVID-19 pandemic could affect quality of care.癌症患者的姑息治疗:新冠疫情如何影响护理质量。
Einstein (Sao Paulo). 2022 May 27;20:eAO6459. doi: 10.31744/einstein_journal/2022AO6459. eCollection 2022.

本文引用的文献

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The Impact of the COVID-19 Pandemic on Cancer Patients.COVID-19 大流行对癌症患者的影响。
Am J Clin Oncol. 2020 Jun;43(6):452-455. doi: 10.1097/COC.0000000000000712.
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Oncology Practice During the COVID-19 Pandemic.COVID-19大流行期间的肿瘤学实践
JAMA. 2020 May 26;323(20):2005-2006. doi: 10.1001/jama.2020.6236.

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