In-hospital end-of-life care in the old: a retrospective study of intensive care unit use and do-not-resuscitate forms in patients deceased in a Belgian university hospital.

IF 1.6 4区 医学 Q2 Medicine
Felicia Bentin, Nele Van Den Noortgate, Ruth Piers
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引用次数: 0

Abstract

Objectives: To explore the quality of in-hospital end-of-life care in adult patients with special attention to those 75 years and older and to make a comparison with the situation 10 years ago.

Methods: Data were retrospectively collected on adult patients who deceased at Ghent University Hospital between September 2018 and December 2019. The main outcome measures were 'ICU use' and 'presence of DNR forms on non-ICU units' in the final hospitalization. In order to identify possible risk factors for ICU use, logistic regression was performed.

Results: In total, 762 people died, of whom 35% were 75 or older. Just as 10 years ago, one-third (31%) died in the ICU versus 49% of those younger than 75 years (p < 0.001). Of people ≥75 years, 38%, compared to 42% 10 years ago, received an ICU treatment during their final hospitalization. The median length of an ICU stay was 4 versus 3 days 10 years ago. After adjusting for gender, comorbidities and the Charlson Comorbidity Index, factors associated with less ICU use were higher age, active malignancy and dementia (OR 0.838, 0.116 and 0.098 respectively). Seventy-nine percent of older patients on non-ICU wards died with a DNR form (versus 87% 10 years ago).

Conclusion: Although there was an increase in the presence of DNR forms in the final hospitalization, no significant differences were seen in actual ICU use compared to 10 years ago. Factors associated with less ICU use were higher age, active malignancy and dementia.

在医院临终关怀在老年人:回顾性研究重症监护病房使用和不复苏形式的病人在比利时大学医院死亡。
目的:探讨75岁及以上成人患者的院内临终关怀质量,并与10年前的情况进行比较。方法:回顾性收集2018年9月至2019年12月在根特大学医院死亡的成年患者的数据。主要观察指标为最终住院时的“ICU使用情况”和“非ICU病房的DNR表存在情况”。为了确定ICU使用的可能危险因素,进行了逻辑回归。结果:共有762人死亡,其中35%的人年龄在75岁及以上。就像10年前一样,三分之一(31%)的患者死于ICU,而75岁以下患者的死亡率为49% (p结论:尽管最终住院时DNR表格的存在有所增加,但与10年前相比,实际使用ICU的情况没有显着差异。与较少使用ICU相关的因素是较高的年龄、活动性恶性肿瘤和痴呆。
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来源期刊
Acta Clinica Belgica
Acta Clinica Belgica 医学-医学:内科
CiteScore
2.90
自引率
0.00%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine primarily publishes papers on clinical medicine, clinical chemistry, pathology and molecular biology, provided they describe results which contribute to our understanding of clinical problems or describe new methods applicable to clinical investigation. Readership includes physicians, pathologists, pharmacists and physicians working in non-academic and academic hospitals, practicing internal medicine and its subspecialties.
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