Departmental Bulletin Paper 滋賀医科大学医学部附属病院における緩和ケア介入の動向に関する後方視的解析

住友, 秀敏  ,  林, 駒紀  ,  服部, 聖子  ,  長谷川, 千晶  ,  森井, 博朗  ,  森田, 幸代  ,  高野, 淳  ,  寺本, 晃治  ,  遠藤, 善裕  ,  醍醐, 弥太郎

30 ( 1 )  , pp.66 - 71 , 2017-03-07 , 滋賀医科大学雑誌編集委員会
We compiled the details of palliative care service (PCS) provided for in-patients with cancer at Shiga University Medical Science Hospital to analyze the trends and problems of PCS retrospectively. [Methods] We analyzed the details of PCS, which was provided by palliative care team (PCT) for cancer patients since April 2012 to November 2016. [Results] The number of patients for whom PCS was provided during these periods was 623, age distributed from 10 to 93 years old (median 66), the numbers of cases with PS of 0, 1, 2, 3 and 4 were 19, 135, 134, 204 and 131, respectively. The proportion of cases with PS 3 and 4 was decreased since 2015. PCS was requested from various departments, mostly from those treating so-called five big cancers (77%). PCS was requested for pain (n=467, 25%), anxiety/depression (n=319, 17%), fatigue (n=225, 12%), family care (n=197, 10%), insomnia (n=149, 8%), regional alliances/support of discharge (n=148, 8%), dyspnea (n=137, 7%), nausea/vomiting (n=117, 6%), delirium (n=65, 4%), and constipation (n=57, 3%), respectively. The proportion of regional alliances/support of discharge was increased since 2015. Outcomes of PCS were, leave hospital mortality (n=233, 40%), discharge (n=209, 35%), changing to palliative care hospital (n=64, 11%), home care (n=45, 8%), and others (n=38, 6%). Durations of PCS intervention ranged from 1 to 181 days (median 16). [Discussion] Although some subtle changes were found recently in the trends of PCS needs, leave hospital mortality has been the most frequent outcome, while only small populations have chosen changing to palliative care hospital or home care, suggesting some hurdles inhibiting the transit from a university hospital to other resources, which will require further investigations.

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