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Quality of transition to end-of-life care for cancer patients in the intensive care unit. / Miller, Sophie J; Desai, Nishita; Pattison, Natalie; Droney, Joanne M; King, Angela; Farquhar-Smith, Paul; Gruber, Pascale C.

In: Annals of intensive care, Vol. 5, No. 1, 25.07.2015, p. 59.

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Miller, Sophie J ; Desai, Nishita ; Pattison, Natalie ; Droney, Joanne M ; King, Angela ; Farquhar-Smith, Paul ; Gruber, Pascale C. / Quality of transition to end-of-life care for cancer patients in the intensive care unit. In: Annals of intensive care. 2015 ; Vol. 5, No. 1. pp. 59.

Bibtex

@article{ccf587fc312243a79bb09d04a02af149,
title = "Quality of transition to end-of-life care for cancer patients in the intensive care unit",
abstract = "BACKGROUND: There have been few studies that have evaluated the quality of end-of-life care (EOLC) for cancer patients in the ICU. The aim of this study was to explore the quality of transition to EOLC for cancer patients in ICU.METHODS: The study was undertaken on medical patients admitted to a specialist cancer hospital ICU over 6 months. Quantitative and qualitative methods were used to explore quality of transition to EOLC using documentary evidence. Clinical parameters on ICU admission were reviewed to determine if they could be used to identify patients who were likely to transition to EOLC during their ICU stay.RESULTS: Of 85 patients, 44.7{\%} transitioned to EOLC during their ICU stay. Qualitative and quantitative analysis of the patients' records demonstrated that there was collaborative decision-making between teams, patients and families during transition to EOLC. However, 51.4 and 40.5{\%} of patients were too unwell to discuss transition to EOLC and DNACPR respectively. In the EOLC cohort, 76.3{\%} died in ICU, but preferred place of death known in only 10{\%}. Age, APACHE II score, and organ support, but not cancer diagnosis, were identified as associated with transition to EOLC (p = 0.017, p < 0.0001 and p = 0.001).CONCLUSIONS: Advanced EOLC planning in patients with progressive disease prior to acute deterioration is warranted to enable patients' wishes to be fulfilled and ceiling of treatments agreed. Better documentation and development of validated tools to measure the quality EOLC transition on the ICU are needed.",
keywords = "palliative, intensive care, communication, do not resuscitate",
author = "Miller, {Sophie J} and Nishita Desai and Natalie Pattison and Droney, {Joanne M} and Angela King and Paul Farquhar-Smith and Gruber, {Pascale C}",
note = "Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.",
year = "2015",
month = "7",
day = "25",
doi = "10.1186/s13613-015-0059-7",
language = "English",
volume = "5",
pages = "59",
journal = "Annals of intensive care",
issn = "2110-5820",
publisher = "Springer-Verlag GmbH and Co. KG",
number = "1",

}

RIS

TY - JOUR

T1 - Quality of transition to end-of-life care for cancer patients in the intensive care unit

AU - Miller, Sophie J

AU - Desai, Nishita

AU - Pattison, Natalie

AU - Droney, Joanne M

AU - King, Angela

AU - Farquhar-Smith, Paul

AU - Gruber, Pascale C

N1 - Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

PY - 2015/7/25

Y1 - 2015/7/25

N2 - BACKGROUND: There have been few studies that have evaluated the quality of end-of-life care (EOLC) for cancer patients in the ICU. The aim of this study was to explore the quality of transition to EOLC for cancer patients in ICU.METHODS: The study was undertaken on medical patients admitted to a specialist cancer hospital ICU over 6 months. Quantitative and qualitative methods were used to explore quality of transition to EOLC using documentary evidence. Clinical parameters on ICU admission were reviewed to determine if they could be used to identify patients who were likely to transition to EOLC during their ICU stay.RESULTS: Of 85 patients, 44.7% transitioned to EOLC during their ICU stay. Qualitative and quantitative analysis of the patients' records demonstrated that there was collaborative decision-making between teams, patients and families during transition to EOLC. However, 51.4 and 40.5% of patients were too unwell to discuss transition to EOLC and DNACPR respectively. In the EOLC cohort, 76.3% died in ICU, but preferred place of death known in only 10%. Age, APACHE II score, and organ support, but not cancer diagnosis, were identified as associated with transition to EOLC (p = 0.017, p < 0.0001 and p = 0.001).CONCLUSIONS: Advanced EOLC planning in patients with progressive disease prior to acute deterioration is warranted to enable patients' wishes to be fulfilled and ceiling of treatments agreed. Better documentation and development of validated tools to measure the quality EOLC transition on the ICU are needed.

AB - BACKGROUND: There have been few studies that have evaluated the quality of end-of-life care (EOLC) for cancer patients in the ICU. The aim of this study was to explore the quality of transition to EOLC for cancer patients in ICU.METHODS: The study was undertaken on medical patients admitted to a specialist cancer hospital ICU over 6 months. Quantitative and qualitative methods were used to explore quality of transition to EOLC using documentary evidence. Clinical parameters on ICU admission were reviewed to determine if they could be used to identify patients who were likely to transition to EOLC during their ICU stay.RESULTS: Of 85 patients, 44.7% transitioned to EOLC during their ICU stay. Qualitative and quantitative analysis of the patients' records demonstrated that there was collaborative decision-making between teams, patients and families during transition to EOLC. However, 51.4 and 40.5% of patients were too unwell to discuss transition to EOLC and DNACPR respectively. In the EOLC cohort, 76.3% died in ICU, but preferred place of death known in only 10%. Age, APACHE II score, and organ support, but not cancer diagnosis, were identified as associated with transition to EOLC (p = 0.017, p < 0.0001 and p = 0.001).CONCLUSIONS: Advanced EOLC planning in patients with progressive disease prior to acute deterioration is warranted to enable patients' wishes to be fulfilled and ceiling of treatments agreed. Better documentation and development of validated tools to measure the quality EOLC transition on the ICU are needed.

KW - palliative

KW - intensive care

KW - communication

KW - do not resuscitate

U2 - 10.1186/s13613-015-0059-7

DO - 10.1186/s13613-015-0059-7

M3 - Article

C2 - 26205668

VL - 5

SP - 59

JO - Annals of intensive care

JF - Annals of intensive care

SN - 2110-5820

IS - 1

ER -