终末期/晚期心力衰竭：老年姑息治疗的考虑因素。

End-Stage/Advanced Heart Failure: Geriatric Palliative Care Considerations.

机构信息

Division of Hospice and Palliative Medicine, Department of Family Medicine, Emory University School of Medicine, Emory University Hospital, 1364 Clifton Road, Atlanta, GA 30322, USA.

Division of General Internal Medicine, Department of Family Medicine, Emory University School of Medicine, Grady Memorial Hospital, 80 Jesse Hill Drive Southeast, Atlanta, GA 30303, USA; Division of Hospice and Palliative Medicine, Department of Family Medicine, Emory University School of Medicine, Grady Memorial Hospital, 80 Jesse Hill Drive Southeast, Atlanta, GA 30303, USA.

出版信息

Clin Geriatr Med. 2023 Aug;39(3):369-378. doi: 10.1016/j.cger.2023.04.010. Epub 2023 May 26.

DOI:10.1016/j.cger.2023.04.010

PMID:37385689

Abstract

Heart failure remains a condition with high morbidity and mortality affecting 23 million people globally with a cost burden equivalent to 5.4% of the total health care budget in the United States. These costs include repeated hospitalizations as the disease advances and care that may not align with individual wishes and values. The coincidence of comorbid conditions with advanced heart failure poses significant challenges in the geriatric population. Advance care planning, medication education, and minimizing polypharmacy are primary palliative opportunities leading to specialist palliative care such as symptom management at end of life and timing of referral to hospice.

摘要

心力衰竭仍然是一种发病率和死亡率都很高的疾病，影响着全球 2300 万人，其医疗费用负担相当于美国总医疗保健预算的 5.4%。这些费用包括随着疾病的进展而反复住院治疗，以及可能不符合个人意愿和价值观的护理。老年人群中心衰合并症的同时存在带来了重大挑战。预先护理计划、药物教育和尽量减少多药治疗是主要的姑息治疗机会，可以导致专科姑息治疗，如生命末期的症状管理和临终关怀的转诊时机。