Incidence of advanced chronic disease, need for palliative care and in-hospital mortality

There is a continuing increase in the prevalence of people affected with progressive chronic diseases. Palliative care is another form of care and organization of health problems that improve quality.

To determine the incidence of patients with advanced chronic illness and need of palliative care (NPC) and intrahospital mortality in a reference hospital.

Prospective observational study in hospitalized patients over 18 years of age in the internal medicine department who met at least one criterion of the NECPAL CCOMS-ICO tool. They were followed until death or discharge to determine intrahospital mortality. We used descriptive and inferential statistics.

We studied 370 admissions from April to August 2021, including 110 patients, 59 women (55.3%) and 51 men (44.7%), age 65.5 ± 15.85 years. The incidence of NPC was 29.7%. The most frequent comorbidity was oncologic in 39 patients (35.5%), followed by chronic heart disease in 17 patients (15.5%); 38 patients were classified as NECPAL grade I (34.5%), 44 NECPAL II (40%) and 28 NECPAL III (25.5%). Twenty-five patients died during their in-hospital stay, with a mortality of 22.7%.

The incidence of hospitalized patients in need of palliative care is considerable, more than half of them for non-oncologic pathology. More effective care strategies are required for external referral and multidisciplinary in-hospital care.