回顾性研究家庭临终关怀的主要恶性脑瘤(S18.004)

文摘

目的:描述临终关怀的时间登记在原发性恶性脑瘤患者(PMBT)背景:PMBT携带相关的不良预后和临终关怀是几乎所有的病人。启动早期多学科的临终关怀与更好的心理保健、缓解疼痛、癌症患者的生活质量,减少成本相比后入学。启动的时机在PMBT临终关怀和相关社会人口和临床特点是未知的。设计/方法:回顾性分析PMBT安宁居家护理的一个城市,非营利性医疗卫生机构提供多学科临终关怀服务。患者包括成人PMBT去世在安宁居家,2009 - 2013。晚临终关怀被定义为起始治疗7天内死亡。临床特点比较早期和晚期临终关怀起始之间。多个逻辑回归进行确定社会人口特征与临终关怀。结果:172例,男性99 (58 [percnt])。临终关怀的时候承认,平均年龄是62.6(标准差16.0)年。 104 (61[percnt]) were white, 24 (14[percnt]) were Hispanic, 14 (8[percnt]) were black, and 30 (18[percnt]) were another race. 37 (21.5[percnt]) had Medicaid as their primary payer. 63 (37[percnt]) did not have a health care proxy (HCP) at admission. 39 (23[percnt]) died within 7 days of initiating hospice care, and as compared to patients referred earlier, a greater proportion were bedbound (OR=23.70; Fisher’s exact p<.001), aphasic (OR=3.4; p=0.004), or comatose (OR=6.45; p=0.005) at admission. Logistic regression demonstrated that late hospice referral was associated with male gender (OR=5.75; p=0.001), Medicaid insurance (OR=5.46; p=0.006), and absence of a HCP (OR=2.99; p=0.009), but not with age or race. Conclusions: PMBT patients referred late to hospice are severely debilitated at initiation of hospice and may not derive benefit from multidisciplinary palliative care. Greater understanding of the mechanism for sociodemographic influences upon late hospice referral is necessary.

披露:博士钻石没有披露。罗素博士没有披露。鲍尔斯博士没有披露。Kryza-Lacombe博士没有披露。博士丹尼斯没有披露。金医生没有披露。皮尔森博士没有披露。