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The relationship between caregivers' perceptions of end-of-life care in long-term care and a good resident death

LEE, Eunyoung ; SUSSMAN, Tamara ; KAASALAINEN, Sharon ; DUREPOS, Pamela ; MCCLEARY, Lynn ; WICKSON-GRIFFITHS, Abigail ; BIMMAN, Rennie
Palliative and supportive care, 15/05/2020, p. 1-8

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Characteristics and outcomes of dementia patients who receive inpatient palliative care consultation

SHARDA, Neema ; ZIETLOW, Kahli ; WONG, Serena ; KUCHIBHATLA, Maragatha ; JOHNSON, Kimberly S.
Journal of the American Geriatrics Society, 16/05/2020, Pagination inconnue

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Thème : Médecine.

DEMENCE ; DEMARCHE PALLIATIVE ; CONSULTATION ; ETUDE RETROSPECTIVE ; PERSONNE AGEE

BACKGROUND/OBJECTIVES: acute hospitalization may be an ideal opportunity to introduce palliative care to dementia patients, who may benefit from symptom management and goals of care discussions. We know little about patients who receive inpatient palliative care consultations (IPCCs).
DESIGN: Retrospective analysis using electronic medical record.
SETTING: Tertiary academic medical center and affiliated community hospital.
PARTICIPANTS: Patients with dementia by International Classification of Diseases diagnosis, 65 years or older, hospitalized between July 1, 2015, and December 31, 2015.
MEASUREMENTS: We used 2 and t -test/Mann-Whitney U test to compare characteristics (living arrangement, advanced dementia markers, diagnoses of delirium and dementia with behavior disturbance, and admitting diagnosis) and outcomes (change in code status, length of stay [LOS], discharge disposition, and discharge medications for symptom management) of patients who did and did not receive IPCC. Patients were matched on sex, age, and race.
RESULTS: Among 927 hospitalized patients with dementia, 17% received IPCC (N = 157). Patients who received IPCC were more likely to be admitted from a nursing facility (35.7% vs 12.7%; P < .0001), experience delirium (71.3% vs 57.3%; P = .01), have behavior disturbance (23.6% vs 13.4%; P = .02), have a pressure ulcer at admission (26.1% vs 11.5%; P = .001), have hypernatremia (12.7% vs 3.2%; P = .002), and be bedbound (20.4% vs 3.2%; P < .000). Patients who received IPCC had a longer LOS (median = 5.9 vs 4.3 days; P = .004) and were more likely to be discharged to hospice (56% vs 3.1%; P < .0001). Patients with IPCC were more likely to have a discharge code status of do not attempt resuscitation (89% vs 46%). There was no significant difference in comfort medications at discharge between groups.
CONCLUSIONS: Patients who received IPCC had evidence of more advanced dementia. These patients were more likely to change their code status and enroll in hospice. IPCC may be useful to prioritize patient-centered care and discuss what matters most to patients and families.

Origine : PubMed

Association between continuous deep sedation and survival time in terminally ill cancer patients

PARK, So-Jung ; AHN, Hee Kyung ; AHN, Hong Yup ; HAN, Kyu-Tae ; HWANG, In Cheol
Supportive care in cancer, 15/05/2020, Pagination inconnue

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Trends and utilization of inpatient palliative care among patients with metastatic bladder cancer

HAN, Hedong ; YU, Feifei ; WU, Cheng ; DAI, Lihe ; RUAN, Yiming ; CAO, Yang ; HE, Jia
JOURNAL OF PALLIATIVE CARE, 14/05/2020, Pagination inconnue

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End-of-life care in an Australian acute hospital - a retrospective observational study

MAUBACH, Ninya ; BATTEN, Monique ; JONES, Scott ; CHEN, Judy ; SCHOLZ, Brett ; DAVIS, Alison ; BROMLEY, Jonathan ; BURKE, Brandon ; TAN, Ren ; HURWITZ, Mark ; RODGERS, Helen ; MITCHELL, Imogen
Internal medicine journal, 01/01/2019, vol.49, n°11, p. 1400-1405

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Understanding end of life preferences - predicting life prolonging treatment preferences among community dwelling older Americans

BRENNER, Allison B. ; SKOLARUS, Lesli E. ; PERUMALSWAMI, Chithra R. ; BURKE, James F.
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 03/05/2020, p. 1-10

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Continuous deep sedation at the end of life in children with cancer - experience at a single center in Japan

MAEDA, Sayaka ; KATO, Itaru ; UMEDA, Katsutsugu ; HIRAMATSU, Hidefumi ; TAKITA, Junko ; ADACHI, Souichi ; TSUNETO, Satoru
Pediatric hematology and oncology, 07/05/2020, p. 1-10

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End-of-life care in cystic fibrosis - comparing provider practices based on lung transplant candidacy

LANGE, Allison V. ; RUESCHHOFF, Ali ; TERAUCHI, Stephanie ; COHEN, Leah ; REISCH, Joan ; JAIN, Raksha ; FINKLEA, James D.
JOURNAL OF PALLIATIVE MEDICINE, 07/05/2020, Pagination inconnue

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The impact of a hospital-community based palliative care partnership - continuum from hospital to home

PARAMANANDAM, Gobi ; BOOHENE, Jeanette ; TRAN, Kelvin ; VOLK-CRAFT, Barbara E.
JOURNAL OF PALLIATIVE MEDICINE, 05/05/2020, Pagination inconnue

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The association of time to palliative medicine consultation on geriatric trauma outcomes

KUPENSKY, Diane T. ; EMERICK, Eric S. ; HILEMAN, Barbara M. ; CHANCE, Elisha A.
Journal of trauma nursing, 06/2020, vol.27, n°3, p. 177-184

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Racial disparities in utilization of palliative care among patients admitted with advanced solid organ malignancies

LEE, Kimberley ; GANI, Faiz ; CANNER, Joseph K. ; JOHNSTON, Fabian M.
The American journal of hospice and palliative care, 06/05/2020, Pagination inconnue

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Impact of palliative care utilization for surgical patients receiving prolonged mechanical ventilation - national trends (2009-2013)

CHATTERJEE, Kshitij ; HARRINGTON, Sarah ; SEXTON, Kevin ; GOYAL, Abhinav ; ROBERTSON, Ronald D. ; CORWIN, Howard L.
The joint commission journal on quality and patient safety, 19/04/2020, Pagination inconnue

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Live discharge from hospice due to acute hospitalization - the role of neighborhood socioeconomic characteristics and race/ethnicity

RUSSELL, David ; LUTH, Elizabeth A. ; RYVICKER, Miriam ; BOWLES, Kathryn H. ; PRIGERSON, Holly G.
Medical Care, 01/01/2020, vol.58, n°4, p. 320-328

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Primary care service use by end-of-life cancer patients - a nationwide population-based cohort study in the United Kingdom

GAO, Wei ; GULLIFORD, Martin ; MORGAN, Myfanwy ; HIGGINSON, Irene J.
BMC family practice, 29/04/2020, vol.21, n°1, p. 1-13

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Risk factors for esophagitis after hypofractionated palliative (chemo) radiotherapy for non-small cell lung cancer

NIEDER, Carsten ; IMINGEN, Kristian S. ; MANNSAKER, Bård ; YOBUTA, Rosalba ; HAUKLAND, Ellinor
Radiation oncology, 01/05/2020, vol.15, n°1, p. 1-6

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Thème : Médecine. Cote : eD03.01.01

RADIOTHERAPIE ; SYMPTOME DIGESTIF ; ETUDE RETROSPECTIVE ; CANCER RESPIRATOIRE

Introduction: Esophagitis influences quality of life and might cause treatment interruption and hospitalization. Previous studies of risk factors focused on curative treatment for non-small cell lung cancer (NSCLC), which often involves concomitant chemoradiation (CRT). Given the uncertainty around extrapolation of dose constraints, we analyzed risk factors in patients treated with hypofractionated palliative regimens.
Patients and methods: A retrospective review of 106 patients treated with palliative radiotherapy or CRT between 2009 and 2017 was performed. Inclusion criteria: prescribed total dose 30–54 Gy, dose per fraction 2.5–4 Gy, esophageal dose > 1 Gy. Uni- and multivariate analyses were performed in 97 eligible patients to identify predictive factors for acute esophagitis grade = 1 (CTCAE 5.0).
Results: Forty percent of patients were treated with 15 fractions of 2.8 Gy (42 Gy) and 28% also received chemotherapy according to the CONRAD study regimen (induction and concomitant Carboplatin/Vinorelbine) published by the Norwegian Lung Cancer Group. Thirty-four percent were treated with 10 fractions of 3 Gy. Stage IV NSCLC was present in 47%. Esophagus Dmax was 39 Gy (population median) and Dmean 15 Gy. Overall 31% of patients developed esophagitis (26% grade 2–3, no grade 4–5). Several dosimetric parameters correlated with the risk of esophagitis (Dmax, Dmean, D5cc, V20, V30, V35, V40). Dmax outperformed other dosimetric variables in multivariate analysis. Furthermore, concomitant chemotherapy significantly increased the risk of esophagitis, while oral steroid medication reduced it. In patients with Dmax =40 Gy a reduced Dmean (=20 Gy) was beneficial.
Conclusion: In order to reduce esophagitis after hypofractionated palliative treatment lower doses than those recommended in curative NSCLC settings are preferable. Besides esophageal dose, CRT is the main risk factor for esophagitis. Additional work is needed to confirm that steroids are able to modify the risk (or to rule out confounding effects of baseline variables not included in our database).

Origine : PubMed

Severe pain at the end of life - a population-level observational study

HAGARTY, A. Meaghen ; BUSH, Shirley H. ; TALARICO, Robert ; LAPENSKIE, Julie ; TANUSEPUTRO, Peter
BMC palliative care, 30/04/2020, vol.19, n°1, p. 1-13

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End-of-life care of hospitalized children with advanced heart disease

LEE, Joowon ; KIM, Gi Beom ; SONG, Mi Kyoung ; LEE, Sang Yun ; KIM, Min Sun ; BAE, Eun Jung
Journal of Korean medical science, 27/04/2020, vol.35, n°16, p. 1-10

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Pediatric palliative care during end of life - a privilege of a few in a tertiary referral hospital from Colombia

CUERVO-SUAREZ, Maria Isabel ; CLAROS-HULBERT, Angélica ; MANZANO-NUNEZ, Ramiro ; MUNOZ, Mauricio ; GARCIA, Ximena
The American journal of hospice and palliative care, 23/04/2020, Pagination inconnue

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Sociodemographic and clinical factors for non-hospital deaths among cancer patients - a nationwide population-based cohort study

ZHUANG, Qingyuan ; LAU, Zheng Yi ; ONG, Whee Sze ; YANG, Grace Meijuan ; TAN, Kelvin Bryan ; ONG, Marcus Eng Hock ; WONG, Ting Hway
Plos one, 2020, vol.15, n°4, p. 1-14

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Preferred place of death in paediatric, teenage and young adult haemato-oncology patients - a retrospective review

STILWELL, Philippa ; BHATT, Ankit ; MEHTA, Keval ; CARTER, Ben ; BISSET, Maggie ; SOANES, Louise ; SHANKAR, Ananth
BMJ supportive and palliative care, 24/03/2020, Pagination inconnue

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