肿瘤急诊科晚期癌症患者的姑息关怀专家会诊结果:回顾性分析

IF 1.2 Q4 HEALTH CARE SCIENCES & SERVICES
Indian Journal of Palliative Care Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI:10.25259/IJPC_232_2024
Sumith Surendran, Jayita Deodhar, Shamali Srinivas Poojary, Pallavi Singh, Prarthna Jayaseelan
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引用次数: 0

摘要

目的:在低收入和中等收入国家(LMIC)环境中,对急诊科(ED)的姑息治疗(PC)咨询及其结果的研究是有限的。本研究旨在评估印度城市三级癌症中心急诊科专科PC (SPC)的晚期癌症患者的PC咨询结果、症状负担和管理,以及转诊模式。材料与方法:回顾性筛选2017年8月至2019年6月在急诊科转介SPC服务的成年晚期癌症患者的数据。记录患者的社会人口学特征、临床特征、急诊科就诊相关数据和治疗相关数据。结果:在644次问诊中,366例(56.8%)出院回家,166例(25.8%)入住不同的环境(医院/临时护理/临终关怀),74例(11.5%)在急诊科死亡,38例(5.9%)到达急诊科时无反应。性别、表现状态(PS)、胃肠道和心血管事件、疼痛、癌症进展和接受药物治疗可预测会诊结果。男性患者和PS较差的患者更有可能进入急诊科,而PS较差和癌症进展的患者更有可能死亡。出院率在女性、有胃肠道症状和疼痛的患者以及接受药物治疗的患者中较高。结论:超过50%的患者转介SPC会诊出院。此外,我们还确定了LMIC-ED环境中每个咨询结果的预测因子。未来的研究应该调查可比较急诊科设置的高级护理计划和生存分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of Specialist Palliative Care Consultation for Patients with Advanced Cancer in an Oncological Emergency Department: A Retrospective Analysis.

Objectives: Research on palliative care (PC) consultation and its outcomes in the emergency department (ED) within a low-and middle-income country (LMIC) setting is limited. This study aimed to evaluate PC consultation outcomes, symptom burden and management, and referral patterns in patients with advanced cancer referred for specialist PC (SPC) in the ED of an urban tertiary care cancer centre in India.

Materials and methods: Data of adult advanced cancer patients referred for SPC services in the ED between August 2017 and June 2019 were retrospectively screened. Patients' sociodemographic features, clinical characteristics, ED visit-related data, and treatment-related data were documented. Multinomial logistic regression, incorporating significant univariate factors, was performed to analyse the independent predictive factors of consultation outcomes in the ED.

Results: Of the 644 consultations, 366 (56.8%) were discharged home, 166 (25.8%) were admitted to various settings (hospital/respite care/hospice), 74 (11.5%) died in the ED, and 38 (5.9%) were unresponsive upon arrival. Sex, performance status (PS), gastrointestinal and cardiovascular events, pain, cancer progression, and receipt of pharmacological treatment were predictive of consultation outcomes. Male patients and those with poor PS were more likely to be admitted to the ED, whereas patients with poor PS and cancer progression were more likely to die. Discharge rates were higher among females, those with gastrointestinal symptoms and pain, and those receiving pharmacological treatment.

Conclusion: More than 50% of the patients referred for SPC consultations were discharged. In addition, we also identified predictors for each consultation outcome in the LMIC-ED setting. Future research should investigate advanced care planning and survival analyses in comparable ED settings.

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来源期刊
Indian Journal of Palliative Care
Indian Journal of Palliative Care HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.30
自引率
0.00%
发文量
57
期刊介绍: Welcome to the website of the Indian Journal of Palliative Care. You have free full text access to recent issues of the journal. The links connect you to •guidelines and systematic reviews in palliative care and oncology •a directory of palliative care programmes in India and IAPC membership •Palliative Care Formulary, book reviews and other educational material •guidance on statistical tests and medical writing.
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