McFarlane Philippa, Sleeman Katherine E, Bunce Catey, Koffman Jonathan, Orlovic Martina, Rosling John, Bearne Alastair, Powell Margaret, Riley Julia, Droney Joanne
The Royal Marsden NHS Foundation Trust, London, England.
The Cicely Saunders Institute, King's College London, London, England.
J Patient Exp. 2023 Jul 30;10:23743735231188826. doi: 10.1177/23743735231188826. eCollection 2023.
Increased advance care planning was endorsed at the start of the Coronavirus disease 2019 (COVID-19) pandemic with the aim of optimizing end-of-life care. This retrospective observational cohort study explores the impact of advanced care planning on place of death. 21,962 records from patients who died during the first year of the pandemic and who had an Electronic Palliative Care Coordination System record were included. 11,913 (54%) had a documented place of death. Of these 5,339 died at home and 2,378 died in hospital. 9,971 (45%) had both a documented place of death and a preferred place of death. Of these, 7,668 (77%) died in their preferred location. Documented elements of advance care planning, such as resuscitation status and ceiling of treatment decisions, were associated with an increased likelihood of dying in the preferred location, as were the number of times the record was viewed. During the COVID-19 pandemic, advanced care planning and the use of digital care coordination systems presented an opportunity for patients and healthcare staff to personalize care and influence end-of-life experiences.
在2019年冠状病毒病（COVID-19）大流行开始时，加强生前预嘱被认可，目的是优化临终护理。这项回顾性观察队列研究探讨了生前预嘱对死亡地点的影响。研究纳入了在大流行第一年期间死亡且有电子姑息治疗协调系统记录的21962例患者的记录。11913例（54%）有记录在案的死亡地点。其中，5339例在家中死亡，2378例在医院死亡。9971例（45%）既有记录在案的死亡地点，也有首选的死亡地点。其中，7668例（77%）在其首选地点死亡。生前预嘱的记录内容，如复苏状态和治疗决定的上限，与在首选地点死亡的可能性增加有关，记录被查看的次数也是如此。在COVID-19大流行期间，生前预嘱和数字护理协调系统的使用为患者和医护人员提供了一个机会，使护理个性化并影响临终体验。
