Department of Emergency Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samut Prakan, Thailand.
Sci Rep. 2024 Nov 4;14(1):26547. doi: 10.1038/s41598-024-77979-2.
Resuscitation interventions are procedures for managing clinical deterioration in patients with life-threatening conditions by securing the airway, maintaining breathing, or supporting circulation. Little is known about differences in the use of resuscitation interventions and the characteristics of patients eligible for palliative care in the emergency department. The objectives of this study are to compare resuscitation interventions in the emergency department between patients with cancer and non-cancer palliative care eligibility. A retrospective cohort study was conducted by reviewing the medical records of the palliative care eligible patients who visited the emergency department of one university hospital between January and June 2019. Among the 956 visits (13.7%) by palliative care eligible patients of 7000 random visits, 480 were patients with cancer (50.2%), and 476 were non-cancer patients (49.8%). The overall median age was 72, and 54.1% were female. The mortality rates in the following year were 35.0% for patients with cancer and 18.7% for non-cancer illnesses. The patients with cancer and non-cancer received prior palliative care at 7.3% and 0.8% (p < 0.001) and initiated palliative care at the emergency department at 6.3% and 2.7%, respectively (p = 0.008). The non-cancer patients utilized overall resuscitation interventions 1.7 times more than the cancer patients (aOR = 1.7, 95% CI = 1.0-2.6, p = 0.030). For the palliative care eligible patients in the emergency department, patients with cancer and non-cancer significantly differed in their characteristics. Patients with non-cancer received more resuscitation interventions than patients with cancer.
复苏干预措施是通过确保气道通畅、维持呼吸或支持循环来管理危及生命的患者临床恶化的程序。对于在急诊科使用复苏干预措施和适合姑息治疗的患者特征方面的差异知之甚少。本研究的目的是比较急诊科癌症和非癌症姑息治疗资格患者的复苏干预措施。通过回顾 2019 年 1 月至 6 月期间在一家大学医院急诊科就诊的姑息治疗合格患者的病历，进行了一项回顾性队列研究。在 7000 次随机就诊中，有 956 次（13.7%）是姑息治疗合格患者，其中 480 例是癌症患者（50.2%），476 例是非癌症患者（49.8%）。总体中位数年龄为 72 岁，54.1%为女性。癌症患者和非癌症患者的 1 年后死亡率分别为 35.0%和 18.7%。癌症和非癌症患者分别有 7.3%和 0.8%（p<0.001）接受了姑息治疗，分别有 6.3%和 2.7%（p=0.008）在急诊科开始接受姑息治疗。非癌症患者的整体复苏干预措施使用次数是非癌症患者的 1.7 倍（aOR=1.7，95%CI=1.0-2.6，p=0.030）。对于急诊科的姑息治疗合格患者，癌症和非癌症患者在特征上存在显著差异。非癌症患者接受的复苏干预措施多于癌症患者。
