End-of-life care for patients hospitalised in internal medicine departments

J. Díez-Manglano, S. Isasi de Isasmendi Pérez, M. Rubio Gómez, F. Formiga, L. Sánchez Muñoz, J. Castiella Herrero, E. Casariego Vales, O. H. Torres Bonafonte, J. Díez-Manglano, Soledad Isasi de Isasmendi Pérez, Marta Rubio Gómez, Magdalena Martín Pérez, Luis Felipe Díez García, Ignacio Vallejo Maroto, Cristina Ocaña Losada, Pilar Giner Escobar, Catalina Díaz Pérez, Javier Caballero Granado, Resfa María García Font, Francisco J. Jódar LorenteGloria Pérez Vázquez, Ana Belén Ferro Expósito, María Luisa Amaya González, Fernando Gamboa Antiñolo, Álvaro González Molina, Mercedes Gómez Hernández, Marcos Guzmán García, Lola Benítez León, Lorena Montero Rivas, María Ruiz Mariscal, Noelia Gómez Aguirre, María Pilar González García, Isabel Martín Algora, María Carmen Bueno Castel, Fernando Ruiz Laiglesia, Esperanza Bejarano Tello, José Luis Cabrerizo García, Nuria Guiral Fernández, Luis Camera, Carla Gauna, Pedro Abad Requejo, Rocío Martínez Gutiérrez, Rebeca Fernández Regueiro, María Teresa Sánchez Vidal, Joaquín Alfonso Mejido, Enrique García Carús, Carmen Elena Calvo Rodríguez, Paula Martínez García, Sixto Ruiz Olivares, María Isabel Fullana Barcelo, Carmen González Arencibia, Rosa Ros Vilamajó, María José Monedero Prieto, Concepción González Becerra, Sofía Pérez, Andrea Martín Plata, Raquel Portilla Chocarro, Carlos Dueñas Gutiérrez, Francisco Estrada Álvarez, Sonia Peña Balbuena, Raúl Rodríguez Galindo, Marta María Cobos Siles, Luis Ángel Sánchez Muñoz, Ana Castañón López, Celia Sanz Lobo, María Montserrat Chimeno Viñas, María Ángeles Contreras Uriel, Judit Gil Domínguez, Francisco Medrano González, José Manuel Machín Lázaro, Jeffrey Magallanes Gamboa, Mónica Rodríguez Galdeano, Joaquín Castro Giménez, José Ramón Barberá Farré, Raquel Núñez Aragón, Ferrán Masanés Torán, José Barbé, Elena Güell Farré, Olga Torres Bonafonte, Ana Lozano Miñana, Desirée Moras Sarabia, Rosa Pérez, Dolors Arnau i Fernández, F. Formiga, Javier Fernández Fernández, Antoni Castro Salomó, Rami Qanneta, María Victoria Pardo Ortega, Cristina Estrada Díaz, Yasmina Monterroso Pintado, Montserrat García Cors, María Cruz Almendros Rivas, Dolors Domingo Albin, Jaume Roig Morera, Nuria Galofré Álvaro, Aythami Toro Parodi, Mario Loureiro Sánchez, Carla de la Guerra Acebal, Javier Zubizarreta García, Iasone Benavente Claveras

Research output: Contribution to journalArticleResearch

4 Citations (Scopus)

Abstract

© 2018 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI) Objectives: To describe the care provided at the end of life for patients who die in internal medicine departments. Methods: An observational, cross-sectional, retrospective multicentre, clinical audit study was conducted where each hospital included the first 10 patients who died in the internal medicine department starting on December 1, 2015. We collected demographic and clinical data and information regarding the circumstances and care at the time of death. Results: The study included 1,447 patients with a median age of 84 years. Of these, 1,065 (74.3%) were polypathological, 751 (51.9%) were terminal and 248 (17.1%) had cancer. For the terminal patients, do-not-resuscitate orders were established for 539 (73.3%), and palliative sedation was performed for 422 (57.4%). There was no record as to whether psychological, religious or grief care was provided in 32%, 64.8% and 44.1% of the terminal patients, respectively. The patients with cancer were more often competent to make decisions (54.4% vs. 15.5%; P <.001), knew their prognosis (42.6% vs. 8.6%; P <.001), received psychological care (24.9% vs. 8.6%; P <.001), died in an individual room (64.6% vs. 44.4%; P <.001) and were accompanied (81.9% vs. 71.9%; P =.003). Their relatives also more frequently received grief care (15.6% vs. 8.2%; P =.002). Conclusions: There is insufficient recording in the medical history as to the end-of-life care. There are differences in the care provided to patients with cancer and to those without cancer.
Original languageEnglish
Pages (from-to)107-115
JournalRevista Clinica Espanola
Volume219
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • Do-not-resuscitate order
  • End-of-life care
  • In-hospital dying
  • Palliative sedation
  • Terminal disease

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