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首页> 外文期刊>The American journal of hospice and palliative care >Palliative medicine in a United States cancer center: a prospective study.
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Palliative medicine in a United States cancer center: a prospective study.

机译：美国癌症中心的姑息医学：一项前瞻性研究。

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PURPOSE: (a) To report the medical complexity of cancer and noncancer patients receiving palliative medicine (PM) consultation at a tertiary medical center and (b) to describe the consult recommendations madefor this group. PATIENTS AND METHODS: Prospective data collection was performed on all consultations (cancer, n = 175; noncancer, n = 35) done by first author (JDC) as a PM fellow at the Cleveland Clinic Foundation between July 1998 and April 1999. A computer database was used to query for demographics, complexity of medical problems, current medications, mortality, symptoms, nursing problems, and consult recommendations. RESULTS: A median of three (range, 0-12) acute medical problems and three (range, 0-16) chronic medical problems were identified for each patient. Patients were taking a median of six medications (range, 0-20). They had a median of five symptoms (range, 0-13) with pain (73 percent) being most common, followed by weakness (40 percent) and shortness of breath (40 percent). Cancer patients were twice as likely to have more than five symptoms (48 percent versus 23 percent) (chi-square = 0.006). The most common nursing problems were ambulation or fall risk (15 percent) and skin integrity (11 percent). A median of five (range, 1-11) management recommendations were made as part of each consultation. These included medication changes in 81 percent, nonmedication changes in 53 percent, andfollow-up services in 100 percent. The median survivalfrom the time of consultation for the known dead was 29 days with 65 percent living more than 14 days. CONCLUSION: Multiple recommendations were made with most patients surviving long enough potentially to benefit. Consultation in palliative medicine is a sophisticated intervention involving considerable acuity and complexity of care.
机译：目的：（a）报告在三级医疗中心接受姑息治疗（PM）咨询的癌症和非癌患者的医疗复杂性，以及（b）描述针对该组的咨询建议。患者和方法：1998年7月至1999年4月期间，第一作者（JDC）作为克利夫兰诊所基金会的PM研究员，对所有咨询（癌症，n = 175;非癌，n = 35）进行了前瞻性数据收集。数据库用于查询人口统计资料，医疗问题的复杂性，当前用药，死亡率，症状，护理问题，并咨询建议。结果：每位患者的中位数为三个（范围为0-12）急性医疗问题和三个（范围为0-16）慢性医疗问题。患者平均服用六种药物（范围0-20）。他们有五个症状的中位数（范围：0-13），其中疼痛（73％）是最常见的，其次是虚弱（40％）和呼吸急促（40％）。癌症患者出现五个以上症状的可能性是其两倍（48％比23％）（卡方= 0.006）。最常见的护理问题是下床或跌倒风险（15％）和皮肤完整性（11％）。每次咨询中均提出了五项建议（范围为1-11）。其中包括用药变化为81％，非用药变化为53％，跟进服务为100％。接受咨询的已知患者中，平均存活时间为29天，其中65％的人存活超过14天。结论：对于大多数患者存活足够长的潜在益处提出了多项建议。姑息治疗中的咨询是一项复杂的干预措施，涉及相当大的敏锐度和复杂的护理。

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