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Palliative approach in acute neurological events: a five-year study
Nuno Ferreira Monteiro1, Patrícia Cipriano2, Elga Freire3
1. Internal Medicine Resident at the Egas Moniz Hospital, Hospital Centre of West Lisbon, Lisboa, Portugal.
Revista Da Associacao Medica Brasileira (1992)
|January 24, 2019
Summary
Patients with acute neurological illness, including stroke, experienced severe symptoms and high mortality. Timely palliative care is crucial for these debilitated patients, as many received futile interventions and lacked adequate symptom management.
Area of Science:
- Neurology
- Palliative Care
- Geriatrics
Background:
- Acute neurological illnesses lead to severe disability and high mortality.
- Survivors often require extensive long-term care.
- Prognosis is often poor, with a 5-year life expectancy around 40%.
Purpose of the Study:
- To evaluate symptoms in patients admitted with stroke, subarachnoid hemorrhage, or subdural hematoma.
- To analyze the role of an In-Hospital Palliative Care Support Team.
- To identify areas for improved patient care and outcomes.
Main Methods:
- Retrospective, observational study.
- Included patients admitted with acute neurological illness and palliative care consultation requests.
- Data collected over a 5-year period (2012-2016) at a tertiary hospital.
Main Results:
- 66 patients (median age 83) with various acute neurological conditions were analyzed.
- Dysphagia (96.8%) and bronchorrhea (48.4%) were prevalent symptoms.
- High in-hospital mortality (72.7%) was observed, with many patients receiving potentially futile interventions and inadequate symptom control.
Conclusions:
- Patients with acute neurological illness are severely debilitated.
- There was a significant delay in requesting palliative care consultations.
- Timely palliative care is essential due to the high morbidity and mortality associated with these conditions.
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