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[Dying in the hospital from an end-stage non-oncologic disease: a decision making analysis]
Francesc Formiga1, Victoria Vivanco, Yazz Cuapio
1UFISS de Geriatría. Servicio de Medicina Interna. Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat. Barcelona, Spain. fformiga@csub.scs.es
Background And Objective:
The aim of the study was to evaluate palliative decision-making in non- oncological patients who died in an acute care hospital.
Patients And Method:
293 patients > 64 years old were analyzed. These patients suffered from dementia (46%), end-stage congestive heart failure (31%) and end-stage chronic obstructive pulmonary disease (23%). We evaluated written information about: do not resuscitate (DNR) orders, graduation of therapeutic decisions, information provided to relatives about prognosis, total withdrawal of other drug therapy and provision of terminal care.
Results:
DNR orders were specified in 37% of cases, graduation of therapeutic decisions in 18% and knowledge of the prognosis by relatives in 57%. Drug withdrawal was carried out in 56% and palliative care in 65% patients.
Conclusions:
Identification and provision of palliative care, in an acute care hospital, of elderly patients at their last admission prior to death because of non-oncological end-stage diseases must be improved.