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[晚期慢性病发病率、姑息治疗需求及住院死亡率]

[Incidence of advanced chronic disease, need for palliative care and in-hospital mortality].

作者信息

Canizal-Oñate José Luis, Tovar-Rodríguez Drusila, León-Armas Norma, Martínez-Díaz Gabriela, López-Zamora Berenice, Cruz-Domínguez María Del Pilar, Arrucha-Cozaya Michelle, Vera-Lastra Olga Lidia, Medina-García Gabriela

机构信息

nstituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Medicina Interna. Ciudad de México, México.

Universidad Veracruzana, Campus Veracruz, Facultad de Medicina. Veracruz, Veracruz, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Mar 4;62(2):1-7. doi: 10.5281/zenodo.10711920.

Abstract

BACKGROUND

There is a continuing increase in the prevalence of people affected with progressive chronic diseases. Palliative care is another form of care and organization of health problems that improve quality.

OBJECTIVE

To determine the incidence of patients with advanced chronic illness and need of palliative care (NPC) and intrahospital mortality in a reference hospital.

METHODS

Prospective observational study in hospitalized patients over 18 years of age in the internal medicine department who met at least one criterion of the NECPAL CCOMS-ICO tool. They were followed until death or discharge to determine intrahospital mortality. We used descriptive and inferential statistics.

RESULTS

We studied 370 admissions from April to August 2021, including 110 patients, 59 women (55.3%) and 51 men (44.7%), age 65.5 ± 15.85 years. The incidence of NPC was 29.7%. The most frequent comorbidity was oncologic in 39 patients (35.5%), followed by chronic heart disease in 17 patients (15.5%); 38 patients were classified as NECPAL grade I (34.5%), 44 NECPAL II (40%) and 28 NECPAL III (25.5%). Twenty-five patients died during their in-hospital stay, with a mortality of 22.7%.

CONCLUSIONS

The incidence of hospitalized patients in need of palliative care is considerable, more than half of them for non-oncologic pathology. More effective care strategies are required for external referral and multidisciplinary in-hospital care.

摘要

背景

受进行性慢性病影响的人群患病率持续上升。姑息治疗是改善健康问题质量的另一种护理和组织形式。

目的

确定一家参考医院中晚期慢性病患者及姑息治疗需求(NPC)的发生率和院内死亡率。

方法

对内科住院的18岁以上患者进行前瞻性观察研究,这些患者至少符合NECPAL CCOMS - ICO工具的一项标准。对他们进行随访直至死亡或出院,以确定院内死亡率。我们使用了描述性和推断性统计方法。

结果

我们研究了2021年4月至8月的370例入院病例,包括110名患者,59名女性(55.3%)和51名男性(44.7%),年龄65.5±15.85岁。NPC的发生率为29.7%。最常见的合并症是肿瘤疾病,共39例(35.5%),其次是慢性心脏病,共17例(15.5%);38例患者被分类为NECPAL I级(34.5%),44例为NECPAL II级(40%),28例为NECPAL III级(25.5%)。25名患者在住院期间死亡,死亡率为22.7%。

结论

需要姑息治疗的住院患者发生率相当高,其中一半以上是因非肿瘤性病理情况。外部转诊和院内多学科护理需要更有效的护理策略。

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