Bucklar Nico, Schettle Markus, Feuz M, Däster F, Christ Sebastian M, Blum David, Hertler Caroline
University of Zurich, Zurich, Switzerland.
Competence Center Palliative Care, Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Support Care Cancer. 2025 Mar 5;33(4):251. doi: 10.1007/s00520-025-09312-0.
The importance of timely integration of palliative care has been confirmed over the past years for any patient suffering from a life-threatening or life-limiting disease. Palliative and supportive care increases quality of life of patients and caregivers in both oncological and non-cancer diseases and should therefore be offered on a needs-based approach and throughout the disease trajectory.
We analyzEd all in-patient consultation requests of the leading university hospital in Switzerland in 2019. Sociodemographics, symptoms, and specific requests as well as provided support offers were retrieved from the electronic patient files. Demographic and clinical data was analyzed by descriptive statistics between groups. Overall survival from diagnosis and time from consultation to death was analyzed by means of Kaplan-Meier estimates and log-rank test.
We identified 507 in-patient consultation requests from 24 oncological and non-oncological departments in 2019. The final analysis cohort comprised 290 patients, of which 133 women (45.9%). Median overall survival of the population from diagnosis was 21.1 months (CI 15.57-26.72). Median survival from palliative care consultation was 29 days (CI 20.89-37.11), independent of primary diagnosis (p = 0.298) or sex (p = 0.079). A total of 38.9% (N = 140) of consultations were requested concurrently to a tumor-targeted treatment. Palliative care consultations provided more support services than requested (p < 0.001).
Our findings underline the persisting late involvement of palliative care services in the disease trajectory, despite being a concurrently consultable and readily available support service to address patient and caregiver needs.
在过去几年中，对于任何患有危及生命或限制生命疾病的患者，及时整合姑息治疗的重要性已得到证实。姑息治疗和支持性护理可提高肿瘤疾病和非癌症疾病患者及其照护者的生活质量，因此应以基于需求的方式并在整个疾病进程中提供。
我们分析了2019年瑞士一家顶尖大学医院的所有住院会诊请求。从电子病历中获取社会人口统计学信息、症状、具体请求以及提供的支持服务。通过组间描述性统计分析人口统计学和临床数据。采用Kaplan-Meier估计法和对数秩检验分析从诊断开始的总生存期以及从会诊到死亡的时间。
我们在2019年确定了来自24个肿瘤和非肿瘤科室的507例住院会诊请求。最终分析队列包括290例患者，其中133例为女性（45.9%）。该人群从诊断开始的中位总生存期为21.1个月（95%置信区间15.57 - 26.72）。从姑息治疗会诊开始的中位生存期为29天（95%置信区间20.89 - 37.11），与原发诊断（p = 0.298）或性别（p = 0.079）无关。总共38.9%（N = 140）的会诊是在进行肿瘤靶向治疗的同时提出的。姑息治疗会诊提供的支持服务比请求的更多（p < 0.001）。
我们的研究结果强调，尽管姑息治疗服务是一项可同时咨询且随时可用的支持服务，能够满足患者和照护者的需求，但在疾病进程中，姑息治疗服务的介入仍然较晚。
