Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio / Prevalence and typology of patients susceptible of palliative care deceased at home

Fundamento: La identificación de pacientes susceptibles de cuidados paliativos (SCP) en la comunidad es fundamental para mejorar su manejo clínico. El objetivo fue comparar, globalmente y por sexo, la tipología de enfermedad de los pacientes SCP y de los identificados como tales. Método: Estudio trasversal de la población de la ciudad de Málaga fallecida en el domicilio durante 2015. Se estudió la asociación entre el tipo de paciente (SCP o identificado como paliativo por inclusión en el Proceso Asistencial Integrado de CP, PAI-CP) y la edad, sexo y tipo de enfermedad, mediante Chi-cuadrado y t de student. Resultados: De los 950 fallecidos, 417 (43,9%) eran SCP y 277 de ellos (66,4%) estaban identificados como tales. Los hombres predominaron en ambas poblaciones (55,6 y 59,9%, respectivamente, p=0,26), de edad media 78,6 y 76,2 años (p=0,01). Las patologías más frecuentes en población SCP fueron cáncer (61,9%), demencias y Alzheimer (19,9%), enfermedad pulmonar obstructiva crónica (EPOC) (6,2%) e insuficiencia cardiaca (4,1%). La proporción de pacientes identificados fue significativamente mayor para cáncer (86,8%) y menor para demencias y Alzheimer (20,5%), EPOC (38,4%) y Parkinson (0,4% de 2,9%). Las mujeres SCP padecían significativamente menos cáncer y EPOC y más demencias. La población incluida en el PAI-CP no mostro diferencias de patología por sexo. Conclusiones: Casi la mitad de fallecidos en domicilio eran SCP, aunque solo 66,4% de los mismos fueron identificados. El cáncer, más frecuente en hombres, fue la enfermedad mas prevalente y frecuentemente identificada, mientras que el 80% de la población con demencia, predominante en mujeres, murió sin ser identificada como paliativa

Background: Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex. Methods: Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student’s test. Results: Of 950 patients attended to after dying at home, 417 (43.9%) were SCP and, of them, 277 (66,4%) were included in the ICP. Males were more frequent in both populations (55.6 and 59.9%, respectively, p=0,26), with mean ages 78.6 and 76.2, respectively (p=0.01). The most frequent diseases in SCP patients were: cancer (61.9%), dementia and Alzheimer (19.9%), chronic obstructive pulmonary disease (COPD) (6.2%), and heart failure (4.1%). People with cancer were more frequently included in the ICP (86.8%), while those with dementia and Alzheimer, COPD and Parkinson were less frequently included (20.5%, 38.4% and 0.4% respectively). By sex, men suffered more from cancer and women from dementia. Percentage of inclusion in ICP was similar for men and women, stratified by disease. Conclusions: Almost half of the people who died at home are SCP although only two out of three are identified as such. Cancer is the most frequent SCP disease and the easiest one to identify, largely affecting men. Three out of four people with dementia died without being identified as PC, and they are mainly women

[Prevalence and typology of patients susceptible of palliative care deceased at home]. / Prevalencia y tipología de pacientes susceptibles de cuidados paliativos fallecidos en el domicilio.

BACKGROUND: Identification of patients susceptible to palliative care (SPC) in the community is essential for improving their clinical management. The objective is to explore the SPC population and their typology of illness, according to sex. METHODS: Cross-sectional study, performed on the population of Malaga who died at home during 2015. Association between type of patient (SCP or identified as palliative by inclusion in the integrated care process (ICP)). Age, sex and type of disease were analyzed with Chi square and t-Student's test. RESULTS: Of 950 patients attended to after dying at home, 417 (43.9%) were SCP and, of them, 277 (66,4%) were included in the ICP. Males were more frequent in both populations (55.6 and 59.9%, respectively, p=0,26), with mean ages 78.6 and 76.2, respectively (p=0.01). The most frequent diseases in SCP patients were: cancer (61.9%), dementia and Alzheimer (19.9%), chronic ob-structive pulmonary disease (COPD) (6.2%) and heart failure (4.1%). People with cancer were more frequently included in the ICP (86.8%), while those with dementia and Alzheimer, COPD and Parkinson were less frequently included (20.5, 38.4 and 0.4% respectively). By sex, men suffered more from cancer and women from dementia. Percentage of inclusion in ICP was similar for men and women, stratified by disease. CONCLUSIONS: Almost half of the people who died at home are SCP although only two out of three are identified as such. Cancer is the most frequent SCP disease and the easiest one to identify, largely affecting men. Three out of four people with dementia died without being identified as PC, and they are mainly women.