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Dying With Dyspnea in the Hospital
Deborah Morris1, Marissa Galicia-Castillo1
11 Eastern Virginia Medical School, Norfolk, VA, USA.
The American Journal of Hospice & Palliative Care
|September 6, 2015
Summary
Many hospitalized patients experience dyspnea (shortness of breath) at the end of life. Healthcare providers often underrecognize and undertreat this symptom, highlighting a need for improved palliative care.
Area of Science:
- Palliative Care
- Symptom Management
- End-of-Life Care
Background:
- Many patients prefer to die at home, yet a significant number die in hospitals.
- Dyspnea (shortness of breath) is a common, often unrecognized and untreated, symptom at the end of life.
Purpose of the Study:
- To determine the prevalence of dyspnea in patients dying in acute hospital care.
- To examine the treatment patterns for dyspnea in this population.
Main Methods:
- Retrospective chart review of 106 deaths at a tertiary care hospital over 3 months.
- Evaluated dyspnea, opioid orders/administration, and palliative care consultation in the last 24 hours of life.
Main Results:
- Dyspnea or tachypnea occurred in 88 of 106 decedents.
- Healthcare providers identified dyspnea in only 50% of cases, even during terminal comfort extubation.
- While opioids were common, few orders specifically targeted dyspnea treatment. Palliative care consultation was associated with increased opioid use and specific dyspnea treatment orders.
Conclusions:
- Findings confirm high prevalence of end-of-life dyspnea in hospitalized patients.
- Underrecognition and suboptimal treatment of dyspnea persist despite national guidelines.
- Collaboration with palliative medicine may enhance assessment and treatment for improved end-of-life care.
Keywords:
breathlessnessdyspneaend-of-life carehospital careopioidspalliative care consultationsymptom prevalenceMore Related Videos
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