The Utilization of Palliative Care Services in Patients with Cirrhosis who have been Denied Liver Transplantation: A Single Center Retrospective Review
Ann. hepatol
;
16(3): 395-401, May.-Jun. 2017. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-887251
ABSTRACT
ABSTRACT Introduction and aim. Utilization of palliative care services in patients dying of end-stage liver disease (ESLD) is understudied. We performed a retrospective review of palliative care services among patients with ESLD unsuitable for liver transplantation (LT) at a tertiary care center. Material and methods. Deceased ESLD patients considered unsuitable for LT from 2007-2012 were identified. Patients were excluded if they received a transplant, had an incomplete workup, were lost to follow up or whose condition improved so LT was not needed. Of the 1,175 patients reviewed, 116 met inclusion criteria. Results. Forty patients (34.4%) received an inpatient palliative care (PC) consultation and forty-one patients (35.3%) were referred directly to hospice. Thirty-three patients (28.4%) transitioned to comfort measures without PC consultation (median survival < 1 day). The median interval between LT denial and PC consultation or hospice was 28 days. Median survival after PC consult or hospice referral was 15 days. In conclusion, in a single center retrospective review of ESLD patients, palliative care services, when utilized, were for care at the very end of life. Without consultation, aggressive interventions continued until hours before death. We propose that ESLD patients could benefit from PC consultation at time of LT evaluation or based on MELD scores.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Transplante de Fígado
/
Prestação Integrada de Cuidados de Saúde
/
Doença Hepática Terminal
Tipo de estudo:
Estudo diagnóstico
/
Estudo prognóstico
Limite:
Humanos
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Ann. hepatol
Assunto da revista:
Gastroenterologia
Ano de publicação:
2017
Tipo de documento:
Artigo
País de afiliação:
Estados Unidos
Instituição/País de afiliação:
Ohio State University/US
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