Semin Arthritis Rheu:风湿病的姑息治疗和临终关怀

2018-11-08 xiangting MedSci原创

大多数患者被疼痛(81.4%)、厌食症(80.1%)和呼吸困难(77%)折磨。

这项研究旨在确定全身性风湿病(SRDs)患者生命最后一年里临终痛苦的程度和高症状患病率的预测因子,以及接受的支持性治疗程度。

研究人员确定了2006年4月1日至2016年4月1日期间死亡的成年SRDs患者。收集了死亡前1年的以下数据:(i)累积症状患病率,(ii)提前医护计划(ACP)率、不复苏(DNR)命令和转诊到姑息治疗医师。研究人员分析了总症状患病率和姑息治疗医生转诊的预测因子。

在研究的161名患者中,34.2%患类风湿性关节炎,21.6%患系统性红斑狼疮。大多数患者被疼痛(81.4%)、厌食症(80.1%)和呼吸困难(77%)折磨。在多因素分析中,具有以下特征的患者总症状患病率较高:(i)年龄较大(β=0.027,SE=0.013,p=0.044); (ii)由Charlson合并症指数衡量的合并症较多(β=0.192,SE=0.159,p=0.044); (iii)入院次数较多(β=0.263,SE=0.090,p=0.004)和(iv)复发感染(β=0.923,SE=0.423,p=0.031)。5名患者(3.1%)接受ACP治疗,25名(15.5%)转诊至姑息治疗医师。转至姑息性治疗与死亡之间的中位时间为8天(IQR 0-19)。在有DNR命令的106名患者中(67.5%),DNR与死亡之间的中位时间为3天(IQR 0-10)。

相关资源:Charlson合并症指数(aCCI)

原始出处:

Jiacai Cho. Palliative and End-of-Life Care in Rheumatology: High Symptom Prevalence and Unmet Needs. Semin Arthritis Rheu. 02 November 2018.

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    2018-11-10 zhaojie88
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    2018-11-10 bbjsj_1984
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