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Carga de Síntomas en Grupos de Enfermedades en Consultas de Cuidados Paliativos
Emmanuelle Bélanger1,2, Sai Pranav Kota3, Rebecca E MacDonell-Yilmaz4,5,6,7
1Center for Gerontology and Healthcare Research, Brown University School of Public Health, Providence, RI, USA.
The American journal of hospice & palliative care
|February 25, 2026
Resumen
Los pacientes de cuidados paliativos experimentan una carga de síntomas significativa, particularmente dolor, ansiedad y disnea. Los servicios de cuidados paliativos (CP) adaptados son cruciales para controlar estos síntomas en diversos diagnósticos.
Área de la Ciencia:
- Cuidados Paliativos; Manejo de Síntomas; Investigación de Servicios de Salud
Sus antecedentes:
- Los cuidados paliativos (CP) tienen como objetivo aliviar el sufrimiento y mejorar la calidad de vida de las personas con enfermedades que limitan la vida.; La investigación existente sobre la carga de síntomas en CP se centra principalmente en pacientes con cáncer fuera de EE. UU., lo que crea la necesidad de datos a gran escala en EE. UU. para diversas condiciones.; Comprender la prevalencia y gravedad de los síntomas es vital para optimizar la prestación de CP.
Objetivo del estudio:
- Caracterizar la carga de síntomas en una gran cohorte de pacientes de cuidados paliativos de EE. UU.; Examinar la prevalencia y gravedad de los síntomas en diferentes grupos de enfermedades.; Evaluar el impacto de las intervenciones de cuidados paliativos en la reducción de los síntomas.
Principales métodos:
- Estudio de cohorte retrospectivo que utiliza métricas de calidad de una agencia de cuidados paliativos de EE. UU.; Inclusión de 5871 pacientes que recibieron cuidados paliativos con al menos una evaluación de la Escala de Evaluación de Síntomas de Edmonton (ESAS) entre julio de 2022 y diciembre de 2023.; Análisis de cinco síntomas clave (dolor, ansiedad, disnea, etc.) calificados en una escala de gravedad de 0 a 10, estratificados por diagnóstico.
Principales resultados:
- Se observó una alta prevalencia inicial de dolor (34,3%), ansiedad (32,3%) y disnea (28,0%).; Se reportaron proporciones significativas de pacientes con dolor de moderado a severo (17,6% moderado, 16,7% severo).; La carga de síntomas varió según el diagnóstico, con altas tasas de dolor en tumores sólidos y enfermedades hepáticas, y alta disnea en enfermedades cardíacas y pulmonares. Entre los pacientes con seguimiento, se observó una mejora sustancial de los síntomas en dolor (33,1%), ansiedad (22,1%) y disnea (19,3%).
Conclusiones:
- Los pacientes de cuidados paliativos presentan una carga de síntomas sustancial que está influenciada por su diagnóstico subyacente.; La planificación eficaz y el acceso a servicios de CP adaptados son esenciales para abordar las diversas necesidades físicas y emocionales de los pacientes.; Los hallazgos subrayan la importancia de las estrategias personalizadas de manejo de síntomas dentro de los cuidados paliativos.
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