Iñigo de Noriega, Ricardo Martino, Raquel Jiménez, Dorleta López de Suso, Blanca Herrero
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引用次数: 0
Abstract
Objective: To analyse differences in the last month of life (LMoL) of patients with paediatric cancer, classified depending on if they were included in an integrated home-hospital paediatric palliative care (PPC) programme with 24-hour assistance or received standard oncology care.
Methods: Retrospective cohort study of deceased patients with cancer in HIU Niño Jesús, where the Pediatric Palliative Care Unit of Madrid (PPCUM) is located. Patients were classified based on being attended or not by the PPCUM. General epidemiological and oncological trajectory characteristics and care in LMoL were compared. A logistic regression model for PPCUM referral was established.
Results: 198 patients were included, with 50% of them attended by the PPCUM. In the LMoL, patients attended by the PPCUM used fewer devices, red blood cells and platelet transfusions, surgery, invasive procedures and palliative sedation. They stayed a mean of 16.8 days less at hospital and 8.6 days in the intensive care unit, with 65.7% of them dying at home, while none of the control group did. In the logistic model, relapse/recurrence events as well as having a solid tumour with long diseases trajectories were associated with being attended by the PPCUM. In patients with haematological cancer, longer trajectories were associated with less possibility of receiving PPCUM attention.
Conclusion: The PPC Integrated home-hospital programmes were associated with less invasive interventions and hospital stay. Patients with haematological cancer seem to experience barriers to our intervention.
期刊介绍：
Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance.
We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication.
In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.
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