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Need for palliative care in patients admitted to emergency departments of three tertiary hospitals: evidence from a Latin-American city
, 1, 1, 1, 1
Affiliations- UNMSM. Medicine Faculty, German Amezaga 375, Lima 15081 Lima, Peru
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Abstract
Background: Emergency departments (ED) serve as a contact point for critically ill patients. According to
experience, a fraction of patients visiting ED present with symptoms and require palliative care; however,
the prevalence of these patients has not been determined in Peru so far.
Objectives: To estimate the prevalence of advanced disease in patients admitted to ED and identify among
them the need for palliative care.
Patients and methods: In the ED of 3 tertiary hospitals in Lima all adult patients had an evaluation of
the medical history and an interview with patients or caregivers. The presence of multiple metastases was
considered advanced cancer, and dementia, neurological, respiratory, hepatic or cardiac disease with functional
dependence or severe deterioration for non-oncological illness. The screening tool was a validated
and adapted palliative care questionnaire.
Results: The prevalence of advanced illness was 7.5% (60 of 797 admissions). The age of patients was
19–96 (median 73.1) years of which 48.3% were females, 23 (39%) patients had oncological and 37 (61%)
patients non-oncological diagnoses. The most frequent symptoms upon admission were dyspnoea, drowsiness,
and pain. A total of 13 (21.7%) of patients with advanced disease were already receiving palliative
care and 8 (13.3%) had controlled symptoms.
Conclusions: Nearly 1 in 13 patients attending ED of tertiary hospitals has advanced disease, of which
80% reported the need for palliative care with less than a quarter of them having received it.
Abstract
Background: Emergency departments (ED) serve as a contact point for critically ill patients. According to
experience, a fraction of patients visiting ED present with symptoms and require palliative care; however,
the prevalence of these patients has not been determined in Peru so far.
Objectives: To estimate the prevalence of advanced disease in patients admitted to ED and identify among
them the need for palliative care.
Patients and methods: In the ED of 3 tertiary hospitals in Lima all adult patients had an evaluation of
the medical history and an interview with patients or caregivers. The presence of multiple metastases was
considered advanced cancer, and dementia, neurological, respiratory, hepatic or cardiac disease with functional
dependence or severe deterioration for non-oncological illness. The screening tool was a validated
and adapted palliative care questionnaire.
Results: The prevalence of advanced illness was 7.5% (60 of 797 admissions). The age of patients was
19–96 (median 73.1) years of which 48.3% were females, 23 (39%) patients had oncological and 37 (61%)
patients non-oncological diagnoses. The most frequent symptoms upon admission were dyspnoea, drowsiness,
and pain. A total of 13 (21.7%) of patients with advanced disease were already receiving palliative
care and 8 (13.3%) had controlled symptoms.
Conclusions: Nearly 1 in 13 patients attending ED of tertiary hospitals has advanced disease, of which
80% reported the need for palliative care with less than a quarter of them having received it.
Keywords
advanced disease, palliative care, need and demand for health services, emergency departments
About this articleTitle
Need for palliative care in patients admitted to emergency departments of three tertiary hospitals: evidence from a Latin-American city
Journal
Palliative Medicine in Practice
Issue
Article type
Research paper
Pages
236-240
Published online
2020-10-26
Page views
856
Article views/downloads
583
DOI
Bibliographic record
Palliat Med Pract 2020;14(4):236-240.
Keywords
advanced disease
palliative care
need and demand for health services
emergency departments
Authors
Jose Percy Amado Tineo
Rolando Vasquez Alva
Roberto Huari Pastrana
Pilar Zelma Huamán Manrique
Teodoro Oscanoa Espinoza
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