Emergency Department Referral for Hospice and Palliative Care Differs among Patients with Different End-of-Life Trajectories: A Retrospective Cohort Study

被引:7
|
作者
Shen, Victor Wei-Che [1 ]
Yang, Che [2 ]
Lai, Li-Ling [2 ]
Chen, Ying-Ju [1 ,3 ]
Huang, Hsien-Hao [1 ,4 ]
Tsai, Shih-Hung [5 ]
Hsu, Teh-Fu [1 ,3 ]
Yen, David Hung-Tsang [1 ,3 ,5 ,6 ]
机构
[1] Natl Yang Ming Chiao Tung Univ, Sch Med, Taipei 112, Taiwan
[2] Taipei Vet Gen Hosp, Dept Nursing, Taipei 112, Taiwan
[3] Taipei Vet Gen Hosp, Dept Emergency Dept, Taipei 112, Taiwan
[4] Natl Yang Ming Chiao Tung Univ, Inst Emergency & Crit Care Med, Coll Med, Taipei 112, Taiwan
[5] Natl Def Med Ctr, Dept Emergency Med, Taipei 114, Taiwan
[6] Yuanpei Univ Med Technol, Dept Nursing, Hsinchu 300, Taiwan
关键词
palliative care; illness trajectory; emergency department; INTENSIVE-CARE; MEDICAL-CARE; ILL PATIENTS; CANCER; CAREGIVERS; QUALITY; ASSOCIATIONS; PREFERENCES; PERCEPTIONS; NATIONWIDE;
D O I
10.3390/ijerph18126286
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Emergency units have been gradually recognized as important settings for palliative care initiation, but require precise palliative care assessments. Patients with different illness trajectories are found to differ in palliative care referrals outside emergency unit settings. Understanding how illness trajectories associate with patient traits in the emergency department may aid assessment of palliative care needs. This study aims to investigate the timing and acceptance of palliative referral in the emergency department among patients with different end-of-life trajectories. Participants were classified into three end-of-life trajectories (terminal, frailty, organ failure). Timing of referral was determined by the interval between the date of referral and the date of death, and acceptance of palliative care was recorded among participants eligible for palliative care. Terminal patients had the highest acceptance of palliative care (61.4%), followed by those with organ failure (53.4%) and patients with frailty (50.1%) (p = 0.003). Terminal patients were more susceptible to late and very late referrals (47.4% and 27.1%, respectively) than those with frailty (34.0%, 21.2%) and with organ failure (30.1%, 18.8%) (p < 0.001, p = 0.022). In summary, patients with different end-of-life trajectories display different palliative care referral and acceptance patterns. Acknowledgement of these characteristics may improve palliative care practice in the emergency department.
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页数:13
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