Adamidis F, Baumgartner N S, Kitta A, Kum L, Ecker F, Bär J, Marosi C, Kreye G, Fischer C, Zeilinger E L, Paschen C, Wenzel C, Masel E K
Department of Medicine I, Division of Palliative Medicine, Medical University of Vienna, Vienna, Austria.
Department of Internal Medicine II, Clinical Division of Palliative Medicine, University Hospital Krems, Krems an Der Donau, Austria.
Support Care Cancer. 2024 Jul 17;32(8):518. doi: 10.1007/s00520-024-08721-x.
A large volume of literature suggests that timely integration of palliative care (PC) enhances the well-being, quality of life and satisfaction of patients and their families. It may also positively impact clinical outcomes and healthcare costs throughout the disease trajectory. Therefore, reviewing clinical practice to reflect real-life situations regarding timely PC integration is essential.
This study, conducted at the Vienna General Hospital between March 2016 and August 2022, retrospectively examined PC consultation (PCC) requests. It aimed to assess the timeliness of PC integration by analysing the duration between diagnosis and the first PCC request, as well as the interval between the first PCC request and death.
This study included 895 PCCs. The median time from diagnosis to the first PCC was 16.6 (interquartile range (IQR): 3.9-48.4) months, while the median time from the first PCC to death was 17.2 (IQR: 6.1-50.7) days. The median time from diagnosis to first PCC was 10.4 months in females (confidence interval (CI): 6.0-14.8) compared to 10.6 months in males (CI: 8.1-13.1; p = 0.675). There were no gender disparities in the time from first PCC to death, with a median of 23.3 days (CI: 15.6-31.0) for females and 22.3 days (CI: 16.2-28.4) for males (p = 0.93). Fifty percent of patients died between 5 and 47 days after the first PCC.
These findings highlight the discrepancy between the clinical perception of PC as end-of-life care and the existing literature, thereby emphasising the importance of timely PC integration.
大量文献表明，及时整合姑息治疗（PC）可提高患者及其家属的幸福感、生活质量和满意度。它还可能对整个疾病进程中的临床结局和医疗成本产生积极影响。因此，回顾临床实践以反映关于及时整合PC的现实情况至关重要。
本研究于2016年3月至2022年8月在维也纳总医院进行，回顾性检查了姑息治疗咨询（PCC）请求。其目的是通过分析诊断与首次PCC请求之间的持续时间以及首次PCC请求与死亡之间的间隔来评估PC整合的及时性。
本研究纳入了895例PCC。从诊断到首次PCC的中位时间为16.6（四分位间距（IQR）：3.9 - 48.4）个月，而从首次PCC到死亡的中位时间为17.2（IQR：6.1 - 50.7）天。女性从诊断到首次PCC的中位时间为10.4个月（置信区间（CI）：6.0 - 14.8），男性为10.6个月（CI：8.1 - 13.1；p = 0.675）。从首次PCC到死亡的时间没有性别差异，女性中位时间为23.3天（CI：15.6 - 31.0），男性为22.3天（CI：16.2 - 28.4）（p = 0.93）。50%的患者在首次PCC后的5至47天内死亡。
这些发现凸显了临床将PC视为临终关怀的认知与现有文献之间的差异，从而强调了及时整合PC的重要性。
