Characteristics, symptom management and outcomes of 101 patients with COVID-19 referred for hospital palliative care
(چکیده مقاله) :
Abstract :
Hospital palliative care is an essential part of the COVID-19 response but data are lacking. We
identified symptom burden, management, response to treatment, and outcomes for a case series of
101 in-patients with confirmed COVID-19 referred to hospital palliative care. Patients (64 male,
median [IQR] age 82 [72-89] years, Elixhauser Comorbidity Index 6 [2-10], Australian-modified
Karnofsky Performance Status 20 [10-20]), were most frequently referred for end of life care or
symptom control. Median [IQR] days from hospital admission to referral was 4 [1-12] days. Most
prevalent symptoms (n) were breathlessness (67), agitation (43), drowsiness (36), pain (23) and
delirium (24). Fifty-eight patients were prescribed a subcutaneous infusion. Frequently used
medicines (median-maximum dose/24h) were opioids (morphine, 10-30mg; fentanyl, 100-200mcg;
alfentanil 500-1000 mcg) and midazolam (10-20mg). Infusions were assessed as at least partially
effective for 40/58 patients, while 13 patients died before review. Patients spent a median [IQR] of 2
[1–4] days under the palliative care team, who made 3 [2–5] contacts across patient, family and
clinicians. At March 30 2020, 75 patients had died, 13 been discharged back to team, home or
hospice, and 13 continued to receive inpatient palliative care. Palliative care is an essential
component to the COVID-19 response, and teams must rapidly adapt with new ways of working.
Breathlessness and agitation are common but respond well to opioids and benzodiazepines.
Availability of subcutaneous infusion pumps is essential. An international minimum
identified symptom burden, management, response to treatment, and outcomes for a case series of
101 in-patients with confirmed COVID-19 referred to hospital palliative care. Patients (64 male,
median [IQR] age 82 [72-89] years, Elixhauser Comorbidity Index 6 [2-10], Australian-modified
Karnofsky Performance Status 20 [10-20]), were most frequently referred for end of life care or
symptom control. Median [IQR] days from hospital admission to referral was 4 [1-12] days. Most
prevalent symptoms (n) were breathlessness (67), agitation (43), drowsiness (36), pain (23) and
delirium (24). Fifty-eight patients were prescribed a subcutaneous infusion. Frequently used
medicines (median-maximum dose/24h) were opioids (morphine, 10-30mg; fentanyl, 100-200mcg;
alfentanil 500-1000 mcg) and midazolam (10-20mg). Infusions were assessed as at least partially
effective for 40/58 patients, while 13 patients died before review. Patients spent a median [IQR] of 2
[1–4] days under the palliative care team, who made 3 [2–5] contacts across patient, family and
clinicians. At March 30 2020, 75 patients had died, 13 been discharged back to team, home or
hospice, and 13 continued to receive inpatient palliative care. Palliative care is an essential
component to the COVID-19 response, and teams must rapidly adapt with new ways of working.
Breathlessness and agitation are common but respond well to opioids and benzodiazepines.
Availability of subcutaneous infusion pumps is essential. An international minimum
(توضیحات تکمیلی) :
(توضیحات تکمیلی) :
Description :
مقاله ISI انگلیسی اصلی
سال انتشار: 2020
فایل ISI انگلیسی اصلی ، با فرمت Pdf
تعداد صفحات فایل ISI انگلیسی اصلی: 15 صفحه
سال انتشار: 2020
فایل ISI انگلیسی اصلی ، با فرمت Pdf
تعداد صفحات فایل ISI انگلیسی اصلی: 15 صفحه
Authors / Descriptions(نویسندگان/توضیحات): سال انتشار 2020 \ مقاله ISI انگلیسی اصلی \ نویسندگان: Natasha Lovell, MBChB BSc MRCP, Matthew Maddocks, BSc MCSP PhD, Simon N. Etkind, MB BChir BA MRCP DTMH, Katie Taylor, BA (Hons)Oxon MSc MBBS MRCP, Irene Carey, MB BCh BAO MSc FRCP, Vandana Vora, MBBS FRCP, Lynne Marsh, BM MSc MRCP, Irene J. Higginson, BMedSci BMBS PhD FMedSci FRCP FFPHM, Wendy Prentice, MBBS MA FRCP, Polly Edmonds, MBBS FRCP, Katherine E. Sleeman, BSc MBBS FRCP PhD
Sent date(تاریخ ارسال) :
1399/02/05 | 4/24/2020
Number of visits(تعداد بازدید):
814
Key words (کلمات کلیدی):
COVID-19, coronavirus, palliative care, symptom management, hospice, end of life
Number of pages(تعداد صفحات) :
15
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