The American journal of hospice & palliative care
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Am J Hosp Palliat Care · Aug 2015
The Relation Between the Timing of Palliative Care and the Frequency and Timing of Do-Not-Resuscitate Orders Among Cancer Deaths in a Tertiary Care Hospital.
The medical records of 246 in-hospital cancer deaths were reviewed to explore the relation between palliative care (PC) timing and the frequency and timing of do-not-resuscitate (DNR) designation. The rate of DNR designation was 100% in patients referred to PC and 82% in those never referred (P < .001). ⋯ The proportion of intensive care unit (ICU) deaths was 0%, 1%, 3%, and 27%, respectively (P < .001). In conclusion, in a tertiary care hospital, earlier PC was associated with earlier DNR designation and less frequent ICU deaths among in-hospital cancer deaths.
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Am J Hosp Palliat Care · Aug 2015
Pain Management for Persons Living With HIV Disease: Experience With Interprofessional Education in Nigeria.
Pain management (PM) has not been routinely incorporated into HIV/AIDS care and treatment in resource-constrained settings. ⋯ Implementing PM in Nigerian HIV clinics requires recognition of cultural beliefs.
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Am J Hosp Palliat Care · Aug 2015
Multiple Cardiopulmonary Resuscitation Attempts in a Community Hospital: Evaluation of the Futility Assessment.
In hospital settings, inadequate recognition of futility of aggressive medical management in patients with terminal disease and lack of the timely transition to palliative care may lead to both excessive and potentially harmful treatment and unnecessary burden on hospital resources. In order to better understand the outcomes of futile medical management and recognize the need for more appropriate end-of-life care, we evaluated the survival of particularly vulnerable cohort of patients in a community hospital who had survived at least 1 cardiorespiratory arrest (CRA) but whose medical problems led to subsequent arrests. ⋯ Adjusting medical care based on futility assessment in patients with chronic illness who survive CRA is often neglected, but crucially relevant step in the optimization of health care system management.
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Am J Hosp Palliat Care · Aug 2015
Comparison of Early Versus Late Palliative Care Consultation in End-of-Life Care for the Hospitalized Frail Elderly Patients.
To examine the effects of early palliative care (PC; EPC; ≤3 days after admission) consultation versus late PC (>3 days) on number of days from day of consult to discharge (DCDAYS), a retrospective review of PC data (2009-2012) included 531 patients with age ≥65 and Palliative Performance Scale ≤50. Early PC was independently associated with lower DCDAYS (P = .019). ⋯ Early PC resulted in lower DCDAYS, fewer inpatient deaths, and higher hospice admissions. Hospice resulted in fewer DCDAYS.
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"Cure" is an important word in oncology but its use in the published literature has not been examined. I investigated all oncology articles using cure in the title field and published in 2012. The definition of cure was examined, specifically whether or not authors use the word to connote some surviving subset of patients who go on to experience outcomes similar to age-matched, normal controls-a definition favored by researchers and employed in survival function analyses. ⋯ There is heterogeneity in the use of the word cure in the literature.