评估预后标准,以确定晚期肺,心脏或肝脏疾病患者的临终关怀资格. 支持调查人员. 研究了解治疗结果和风险的预测和偏好.

E Fox¹, K Landrum-McNiff, Z Zhong

¹Center to Improve Care of the Dying, George Washington University School of Medicine and Health Sciences, Department of Veterans Affairs, Washington, DC 20420, USA. ellen.fox@mail.va.gov

JAMA

|November 30, 1999

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目前的标准无法准确识别需要临终关怀的晚期肺部,心脏或肝脏疾病的重病患者,因为大多数患者的存活时间超过六个月. 这影响了终身护理的资格.

科学领域:

抚慰性护理是一种缓解性护理.
预测医学是一种预测医学.
慢性疾病管理慢性疾病管理

背景情况:

对于患有晚期肺部,心脏或肝脏疾病的绝症患者,建议提供临终关怀护理.
获得临终关怀的资格通常需要预后为不到六个月的生存期.
准确识别预后有限的患者对于及时获得息服务至关重要.

研究的目的:

评估现有临床标准的有效性,以确定患有晚期慢性疾病 (COPD,CHF,肝病) 的重病住院患者,预后生存期为≤6个月.
评估临终关怀医院资格的一般和疾病特定标准的准确性.
检查综合标准 (广泛,中等,狭窄) 在预测短期生存方面的表现.

主要方法:

验证研究利用研究数据来了解治疗结果和风险的预测和偏好 (SUPPORT).
对2607名患有晚期慢性阻塞性肺病,充血性心力衰竭或末期肝病的重病住院患者的分析.
评估了5个一般性和2个特定疾病的临床标准,以及3个组合标准,并进行了6个月的随访.

主要成果:

大多数 (75%) 的研究样本在出院后的6个月内幸存下来.
广泛的纳入标准确定了923名临终关怀患者,但70%的患者存活时间超过6个月.

关键词:

死亡和安乐死是死亡和安乐死.经验方法的实证方法.国家临终关怀组织国家临终关怀组织了解治疗结果和风险的预测和偏好研究 (SUPPORT)

中间和狭窄的标准也显示了有限的准确性,高比例的患者存活超过6个月 (分别为65%和53%),这表明短期预后的特异性很低.

结论:

目前的临床预测标准对于准确识别患有晚期COPD,CHF或肝脏疾病的重病住院患者,其生存预后为6个月或更短,是无效的.
这些发现表明需要修订或制定新的标准,以改善对这种患者群体的住院资格确定.
提高预后准确度至关重要,以确保慢性致命疾病患者获得适当的终身护理.

相关实验视频

评估预后标准,以确定晚期肺,心脏或肝脏疾病患者的临终关怀资格. 支持调查人员. 研究了解治疗结果和风险的预测和偏好.

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[Interpretation of expert consensus on primary tumor management for metastatic colorectal cancer (2026 edition)].

Managing Listeria by Cleaning and Disinfection: Experiences from Food Processing Industries and from Manufacturers of Cleaning and Disinfection Agents.

[Three-year survival outcomes of neoadjuvant immunotherapy for local advanced rectal cancer with pMMR: a single-center report of 140 patients from Peking University Cancer Hospital].

Operational strategies among infectious disease clinical trial sites during pandemics: a scoping review.

[Emphasizing whole-course management of colorectal cancer: from diagnosis and treatment to patient health].

The Food Environment Perceptions Survey: development and piloting of a survey instrument in India and Cambodia to assess consumers' interactions with diverse food environments.

相关实验视频

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[Interpretation of expert consensus on primary tumor management for metastatic colorectal cancer (2026 edition)].

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[Three-year survival outcomes of neoadjuvant immunotherapy for local advanced rectal cancer with pMMR: a single-center report of 140 patients from Peking University Cancer Hospital].

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[Emphasizing whole-course management of colorectal cancer: from diagnosis and treatment to patient health].

The Food Environment Perceptions Survey: development and piloting of a survey instrument in India and Cambodia to assess consumers' interactions with diverse food environments.

科学领域:

背景情况:

研究的目的:

主要方法:

主要成果:

结论: