The Utilization of Palliative Care Services in Patients with Cirrhosis who have been Denied Liver Transplantation: A Single Center Retrospective Review
Título del documento: The Utilization of Palliative Care Services in Patients with Cirrhosis who have been Denied Liver Transplantation: A Single Center Retrospective Review
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000407817
ISSN: 1665-2681
Autores: 1
2
3
2
2
24
Instituciones: 1Ohio State University, Columbus, Ohio. Estados Unidos de América
2University of Wisconsin, Madison, Wisconsin. Estados Unidos de América
3Northwestern University, Chicago, Illinois. Estados Unidos de América
Año:
Periodo: May-Jun
Volumen: 16
Número: 3
Paginación: 395-401
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Utilization of palliative care services in patients dying of end-stage liver disease (ESLD) is understudied. We performed a retrospective review of palliative care services among patients with ESLD unsuitable for liver transplantation (LT) at a tertiary care center. Material and methods. Material and methods. Material and methods. Deceased ESLD patients considered unsuitable for LT from 2007-2012 were identified. Patients were excluded if they received a transplant, had an incomplete workup, were lost to follow up or whose condition improved so LT was not needed. Of the 1,175 patients reviewed, 116 met inclusion criteria. Results. Results. Results. Forty patients (34.4%) received an inpatient palliative care (PC) consultation and forty-one patients (35.3%) were referred directly to hospice. Thirty-three patients (28.4%) transitioned to comfort measures without PC consultation (median survival < 1 day). The median interval between LT denial and PC consultation or hospice was 28 days. Median survival after PC consult or hospice referral was 15 days. In conclusion, in a single center retrospective review of ESLD patients, palliative care services, when utilized, were for care at the very end of life. Without consultation, aggressive interventions continued until hours before death. We propose that ESLD patients could benefit from PC consultation at time of LT evaluation or based on MELD scores
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Terapéutica,
Cirrosis hepática,
Enfermedades terminales,
Cuidados paliativos,
Calidad de vida
Keyword: Medicine,
Gastroenterology,
Therapeutics,
Liver cirrhosis,
Terminal diseases,
Palliative care,
Quality of life
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