Implementation Status of Palliative Care for Patients Died in Peking Union Medical College Hospital,2019 / 中国医学科学院学报

Objective To reveal the current situation of palliative care for patients who died in Peking Union Medical College Hospital,so as to guide the practice of palliative care for patients in terminal stage. Methods A retrospective study was conducted on patients who died in Peking Union Medical College Hospital from January 1,2019 to December 31,2019.The general clinical data of the patients,whether they received palliative care,and the treatment details including invasive rescue measures,symptom controlling,and psychological,social,and spiritual care status before dying were collected for descriptive analysis. Results A total of 244 inpatients died in 2019,including 135 males and 109 females,with an average age of (65.9±16.4) years (1 day to 105 years).Among the 244 patients,112 (45.9%) died of neoplastic diseases and 132 (54.1%) died of non-neoplastic diseases.Sixty-one (25.0%) patients received palliative care before death,and they were mainly distributed in internal medicine departments such as nephrology (100.0%),gastroenterology (80.0%),and geriatrics (72.7%).Twenty-nine patients received sound palliative care,with all symptoms under control and no invasive treatment before death,and twenty-six patients received psychological,social,and spiritual care.Compared with the patients who were not exposed to the concept of palliative care,the patients who received palliative care showed decreased probabilities of cardiopulmonary resuscitation (0 vs 20.2%;χ2=13.009,P<0.001),tracheal intubation (3.3% vs 48.6%;χ2=38.327,P<0.001),and invasive mechanical ventilation (4.9% vs 47.5%;χ2=33.895,P<0.001) and an increased probability of psychological,social,and spiritual care (54.1% vs 2.4%;χ2=91.486,P<0.001). Conclusion The concept of palliative care has a positive impact on the death of end-stage patients.Palliative care services can increase the probability of end-stage patients receiving psychological,social,and spiritual care and reduce the use of invasive treatment.

Effect of Concept and Practice of Palliative Care on the Death Status of Patients in Peking Union Medical College Hospital / 中国医学科学院学报

Objective To analyze the changes of death status of the inpatients in Peking Union Medical College Hospital before and after the development of palliative care.Methods All the death cases of Peking Union Medical College Hospital in 2013 (384 cases) and 2019 (244 cases) were included in this study,and the general information of the patients and the details of diagnosis and treatment before death were collected.Results The departments of intensive care,emergency,and respiratory diseases and the international medical services had highest number of deaths in both 2013 and 2019,with the cumulative constituent ratios of 67.7% and 62.7%,respectively.The number of clinical departments that involved or implemented palliative care increased from 7 in 2013 to 14 in 2019.The number of patients who died in 2019 and exposed to palliative care increased (P<0.001) compared with that in 2013,and increasing patients received humanistic care (P<0.001).Compared with 2013,2019 witnessed reducing patients receiving vasoactive drugs (P=0.006),cardiopulmonary resuscitation (P=0.002),endotracheal intubation (P=0.002),invasive mechanical ventilation (P<0.001),and invasive operation (P<0.001) before death in 2019.Conclusion The concept and practice of palliative care have significantly reduced the proportion of terminal patients receiving traumatic treatment.