The patient with terminal illness in the acute care hospital: the palliative care advisory team

Objectives: To determine the characteristics of palliative inpatient characteristics in an acute care hospital. To analyse the factors that determine the discharge location. Material and method: A descriptive study of patients referred to the Palliative Care Advisory Team between October 2008 and September 2009. The comparison of parametric values was performed using the chi squared test and the Student t-test. Results: A total of 198 patients (74% with cancer) were evaluated, with 19 readmissions. There were 63% men, with a mean age 75 +/- 12 years. The mean Barthel index was 25 27 and Palliative Performance Scale (PPS) 42 +/- 11. The mean time from assessment to discharge was 3.6 +/- 4 days. The most frequent symptoms were asthenia (85.6%), anorexia (72%), xerostomia (67.2%), pain (63.6%), insomnia (57.8%), and dyspnea (52.3%). We found significant differences between cancer and non-cancer patients (P<.05), in mean age (74 vs 79 years, respectively), Barthel index (31 vs 14), PPS (43 vs 39) and the average number of days from admission to the request for evaluation (9 vs 18). Non-cancer patients are not included in the program and more often leave the program after discharge (P<.05). Patients referred to long-term care hospital have a lower Barthel index and lower PPS than patients discharged to home (P<.05). Conclusions: Palliative inpatients at acute care hospital have a significant functional impairment, more marked in non-cancer. Non-cancer patients are referred later and have more difficulty for inclusion in the program. The factor most often determined the discharge location was the functional status. (C) 2010 Sociedad Espanola de Cuidados Paliativos. Published by Elsevier Espana, S.L. All rights reserved.