Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
James J. Peters Veterans Affairs Medical Center, Geriatric Research Education and Clinical Center (GRECC), Bronx, New York, USA.
J Palliat Med. 2023 Oct;26(10):1398-1400. doi: 10.1089/jpm.2023.0265. Epub 2023 Jul 13.
In order to improve early access to palliative care, strategies for monitoring referral practices in real-time are needed. To evaluate how Australia-Modified Karnofsky Performance Status (AKPS) at the time of initial palliative care consult differs between serious illnesses and could be used to identify opportunities for earlier referral. We retrospectively evaluated data from an inpatient palliative care consult registry. Serious illnesses were classified using ICD-10 codes. AKPS was assessed by palliative care clinicians during consult. The AKPS distribution varied substantially between the different serious illnesses ( < 0.001). While patients with cancer and heart disease often had preserved functional status, the majority of patients with dementia, neurological, lung, liver, and renal disease were already completely bedbound at the time of initial palliative care consult. Measuring functional status at the time of palliative care referral could be helpful for monitoring referral practices and identifying opportunities for earlier referral.
为了提高获得姑息治疗的机会，需要制定实时监测转介实践的策略。本研究旨在评估澳大利亚改良 Karnofsky 表现状态（AKPS）在初始姑息治疗咨询时在不同严重疾病之间的差异，以及是否可以用于确定更早转介的机会。我们回顾性地评估了住院姑息治疗咨询登记处的数据。严重疾病使用 ICD-10 代码进行分类。姑息治疗临床医生在咨询期间评估 AKPS。AKPS 分布在不同严重疾病之间差异很大（ < 0.001）。虽然癌症和心脏病患者的功能状态通常保持良好，但大多数痴呆症、神经、肺部、肝脏和肾脏疾病患者在初始姑息治疗咨询时已经完全卧床不起。在姑息治疗转介时测量功能状态可能有助于监测转介实践和确定更早转介的机会。
