Background
Methods
Data sources
Variables
Statistical analysis
Results
Patient characteristics
Characteristics | Men (N = 22) | Women (N = 35) |
---|---|---|
Mean (SD) | Mean (SD) | |
Age at the receiving palliative care (y/o) | 88.2 (5.6) | 89.2 (5.2) |
Duration from entry the nursing home to the receiving palliative care (years) | 4.7 (4.1) | 5.2 (4.2) |
Duration from first family meeting to the entry of palliative care (days) | 24.1 (78.1) | 19.2 (45.8) |
The person signed contract of palliative care | N (%) | N (%) |
Couple | 4 (18.2) | 1 (2.9) |
Child | 14 (63.6) | 30 (85.7) |
Others | 4 (18.2) | 4 (11.4) |
Family members participated Family meeting | ||
1–2 | 15 (68.2) | 26 (71.1) |
> 2 | 7 (31.8) | 9 (28.9) |
Times of Family Meeting | ||
1 | 25 (92.6) | 30 (78.9) |
2 (twice) | 2 (7.4) | 7 (18.4) |
Service evaluation
Characteristics (Average number per month) | Pre-palliative-care stageb (N = 57) | Post-palliative-care stagec (N = 57) | Statisticsa |
---|---|---|---|
Mean (SD) | Mean (SD) | ||
The departments visited | 2.23 (0.96) | 0.07 (0.26) | P < 0.001 |
Number of medications | 7.84 (3.04) | 5.39 (2.51) | P < 0.001 |
Number of hospitalizations | 1.42 (1.45) | 0.07 (0.32) | P < 0.001 |
Length of stay (days) | 19.72 (22.74) | 0.56 (3.21) | P < 0.001 |
Length of stay of ICU admissions (days) | 1.49 (5.82) | 0.00 (0.00) | P = 0.058 |
Number of visits on emergency department | 0.39 (0.82) | 0.02 (0.13) | P = 0.001 |
Factors associated with middle-term mortality
Characteristics | Mortality within 6 months after palliative care (N = 23) | Survival at least 6 months after palliative care (N = 34) | |||
---|---|---|---|---|---|
Before palliative care (baseline) | N (%) | N (%) | Odds ratioa | 95% CIa | P valuea |
Age at receiving palliative care (y/o) | |||||
≤ 85 | 5 (18.5) | 6 (17.6) | Reference | – | – |
86–90 | 8 (29.6) | 15 (44.1) | 0.64 | 0.15–2.77 | 0.550 |
> 90 | 10 (51.9) | 13 (38.2) | 0.92 | 0.22–3.92 | 0.914 |
Number of departments visited per month before palliative care | |||||
1 | 2 (8.7) | 9 (26.5) | Reference | – | – |
2 | 13 (56.5) | 17 (50.0) | 3.44 | 0.63–18.72 | 0.153 |
> 2 | 8 (34.8) | 8 (23.5) | 4.50 | 0.73–27.74 | 0.105 |
Number of medications used per month before palliative care | |||||
0–5 | 2 (8.7) | 10 (29.4) | Reference | – | – |
> 5 | 21 (91.3) | 24 (70.6) | 4.38 | 0.86–22.27 | 0.075 |
Number of admissions within 1 year before palliative care | |||||
0 | 5 (21.7) | 9 (26.5) | Reference | – | – |
1 | 6 (26.1) | 20 (58.8) | 0.54 | 0.13–2.24 | 0.396 |
> 1 | 12 (52.2) | 5 (14.7) | 4.32 | 0.95–19.58 | 0.058 |
ICU admission within 1 year before palliative care | |||||
Yes | 4 (17.4) | 1 (2.9) | Reference | – | – |
No | 19 (82.6) | 33 (97.1) | 0.14 | 0.02–1.38 | 0.093 |
Number for ER visits within 1 year before palliative care | |||||
0 | 18 (78.3) | 25 (73.5) | Reference | – | – |
1–6 | 5 (21.7) | 9 (26.5) | 0.77 | 0.22–2.69 | 0.684 |
At receiving palliative care | |||||
Cognitive impairment | |||||
Severe | 23 (100) | 31 (91.2) | Reference | – | – |
Moderate | 0 (0) | 2 (5.9) | 0 | 0 | 1.000 |
Mild | 0 (0) | 1 (2.9) | 0 | 0 | 0.999 |
Mobility | |||||
Bedridden | 22 (95.7) | 26 (76.5) | Reference | – | – |
Wheelchair | 1 (4.3) | 8 (23.5) | 0.15 | 0.02–1.28 | 0.082 |
Intake | |||||
NG tube feeding | 20 (87.0) | 28 (82.4) | Reference | – | – |
Oral feeding | 2 (8.6) | 6 (17.6) | 0.47 | 0.09–2.56 | 0.380 |
Gastroenteric tube feeding | 1 (4.3) | 0 (0) | 2.26 | 0 | 1.000 |
Urination | |||||
Diaper | 13 (56.5) | 20 (58.8) | Reference | – | – |
urinary tube | 9 (39.1) | 11 (32.4) | 1.26 | 0.41–3.87 | 0.688 |
Bladder fistula/Intestinal fistula | 1 (4.3) | 3 (8.8) | 051 | 0.48–5.48 | 0.581 |
Respiratory function | |||||
Spontaneous respiration | 6 (26.1) | 16 (47.1) | Reference | – | – |
Tracheostomy | 2 (8.7) | 1 (2.9) | 5.33 | 0.41–70.20 | 0.203 |
Need oxygen | 15 (39.1) | 17 (47.1) | 2.35 | 0.73–7.56 | 0.151 |
Barthel Index, mean/SD | 0 (0) | 0 (0) | – | – | – |
MMSE, mean [23] | 9.95 (0.31) | 9.87 (0.52) | 0.82 | 0.20–3.35 | 0.778 |
After palliative care | |||||
Number of departments visited per month after palliative care | |||||
0 | 21 (91.3) | 32 (94.1) | Reference | – | – |
≥ 1 | 2 (8.7) | 2 (5.9) | 1.52 | 0.20–11.67 | 0.685 |
Number of medications use per month after palliative care | |||||
0–5 | 10 (43.5) | 22 (64.7) | Reference | – | – |
> 5 | 13 (56.5) | 12 (35.3) | 2.38 | 0.81–7.04 | 0.116 |
Number of admissions after palliative care | |||||
0 | 21 (91.3) | 33 (97.1) | Reference | – | – |
≥ 1 | 2 (8.7) | 1 (2.9) | 3.14 | 0.27–36.86 | 0.362 |
ICU admission after palliative care | |||||
Nil | 23 (100) | 34 (100) | |||
Number of ER visits after palliative care | |||||
0 | 23 (100) | 33 (97.1) | Reference | – | – |
1 | 0 (0) | 1 (2.9) | 0.00 | 0 | 1.000 |