Changes in the Death Status of End-of-life Patients After Concept Promotion and Practice of Palliative Care
10.12290/xhyxzz.2023-0648
- VernacularTitle:发展缓和医疗理念和实践后终末期患者死亡状况变化
- Author:
Xiaoyan DAI
1
;
Jing YAN
2
;
Youpei WANG
3
;
Xiaohong NING
4
,
5
Author Information
1. Department of International Medical Services, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
2. Department of General Practice, the First People's Hospital of Nanning, Nanning 530000, China
3. Department of Geriatrics, Qingdao Chengyang People's Hospital, Qingdao, Shandong 266109, China
4. Department of Geriatric, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
5. Palliative Medicine Center, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Publication Type:Journal Article
- Keywords:
end-of-life;
palliative care;
concept promotion;
consultation;
death status
- From:
Medical Journal of Peking Union Medical College Hospital
2024;15(1):84-88
- CountryChina
- Language:Chinese
-
Abstract:
Objective The International Medical Services Department of Peking Union Medical College Hospital (PUMCH) has gradually promoted the concept and practice of palliative care since 2016. This study aims to analyze the death status of end-of-life patients before and after the promotion endeavor, in order to evaluate the impact of palliative care on the death quality. Methods All clinical data from end-of-life patients who died at the International Medical Services Department of PUMCH in 2013 and 2019 were retrospectively collected, and their diagnosis and treatment details before death were compared. Results A total of 36 end-of-life patients who died in 2013 and 37 end-of-life patients who died in 2019 met the inclusion and exclusion criteria. In 2013, there were 19 males and 17 females, with an average age of (72.1±14.0) years, and 19 cases had advanced cancer. In 2019, there were 19 males and 18 females, with an average age of (70.8±15.3) years, and 27 cases had advanced cancer. Compared to patients who died in 2013, a lower proportion of the patients in 2019 who were transferred to the ICU before death(0 vs. 22.2%, P=0.008), received cardiopulmonary resuscitation (0 vs. 16.7%, P=0.011), had tracheal intubation(5.4% vs. 36.1%, P=0.001), invasive mechanical ventilation(2.7% vs. 33.3%, P=0.001), and total parenteral nutrition(32.4% vs. 61.1%, P=0.014), while a higher proportion received palliative care consultations(29.7% vs. 0, P<0.001), and humanistic care(40.5% vs. 16.7%, P=0.024). In 2019, compared to the patients who did not receive palliative care consultations, those who received palliative care consultations had a higher proportion of humanistic care(90.9% vs. 19.2%, P<0.001). Conclusions After concept promotion and practice of palliative care, the proportion of end-of-life patients receiving invasive treatments before death in the International Medical Services Department of PUMCH has significantly decreased, the proportion receiving humanistic care has significantly increased, and the quality of death has been improved to a certain extent.
