生命终点护理计划外血管病患者的入院
Henry Davies1, Nawaz Z Safdar2, Jing Yi Kwan1
1Leeds Vascular Institute, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Annals of vascular surgery
|October 18, 2023
概括
在英国,无计划血管外科手术患者的终身护理 (EoLC) 是不够的,质量也很差. 需要指导方针,以确保这些高死亡率的患者及时接受息治疗咨询.
科学领域:
- 血管外科 血管外科
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 无计划的血管入院与高死亡率有关.
- 现有的关于英国这一群体生命终端护理 (EoLC) 的数据有限.
- 这项研究旨在评估英国第三级血管入院的EoLC质量和预测因素.
研究的目的:
- 评估为接受无计划血管手术的患者提供终身护理 (EoLC) 的质量.
- 在这个高风险患者群体中确定EoLC质量的预测因素.
- 评估息治疗咨询 (PCC) 在改善EoLC方面的有效性.
主要方法:
- 对无计划血管外科手术入院的回顾性单中心队列研究 (2019年8月 - 2020年1月).
- 收集关于人口统计,息护理标志物,死亡率和死亡原因的数据.
- 定义为缓和护理咨询 (PCC) 的EoLC输入;慢性肢体威胁性缺血症 (CLTI),糖尿病脚和破裂的大动脉动脉瘤的子组分析.
主要成果:
- 包括150名患者;中位数年龄70.5岁,72%男性;CLTI最常见的原因 (31%).
- 两年死亡率为36%;肺炎是最常见的死亡原因 (22%).
- 只有7%的人接受了PCC (死亡前10天的中位数);提前护理规划文档较低 (14-37%).
结论:
- 尽管死亡率高,但生命终端护理质量不足以应对无计划血管外科手术的入院.
- 临床指导方针和途径至关重要,以确保针对特定高风险疾病考虑并默认提供EoLC.
- 需要进一步的研究来确定血管患者谁会从早期的EoLC干预中受益.
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