PDF(Pubmed)
Abstract：
UNASSIGNED: The coronavirus disease 2019 (COVID-19) pandemic resulted in complex physical and psychosocial symptom burden at end of life. The benefit of specialist palliative care input in other disease states has been established, however, there is little evidence on referral patterns to these services in patients dying from COVID-19.
UNASSIGNED: This retrospective audit investigated the referral patterns for patients who died from COVID-19 at a quaternary hospital in South Australia (the Royal Adelaide Hospital) over a six-month period in 2022, and whether demographic features or COVID-19 specific factors had an impact on whether these patients received specialist palliative care services (PCS). The second aim was to identify prescription patterns for patients in the last 24 hours of life, and whether this was impacted by referral.
UNASSIGNED: Data were obtained from electronic medical records and analyzed using binary logistic regressions for referral to PCS versus no referral based on various predictors.
UNASSIGNED: There was no significant difference comparing patient demographics or COVID-19 specific factors with referral to PCS. There was statistical significance between patients who received referral to PCS and those who had a higher oral morphine equivalent daily dose (OMEDD) in the 24 hours before death, as well as the presence of a continuous subcutaneous infusion. Although the cause of this relationship is undetermined, it may represent the prescription patterns of the palliative care physicians during consultation or potentially higher symptom burden prompting referral. There was also a higher proportion of patients who received hydromorphone compared with other opioids, though the OMEDD was consistent with other published literature.
UNASSIGNED: This retrospective audit investigated the referral patterns for patients who died from COVID-19 at a quaternary hospital in South Australia (the Royal Adelaide Hospital) over a six-month period in 2022, and whether demographic features or COVID-19 specific factors had an impact on whether these patients received specialist palliative care services (PCS). The second aim was to identify prescription patterns for patients in the last 24 hours of life, and whether this was impacted by referral.
UNASSIGNED: Data were obtained from electronic medical records and analyzed using binary logistic regressions for referral to PCS versus no referral based on various predictors.
UNASSIGNED: There was no significant difference comparing patient demographics or COVID-19 specific factors with referral to PCS. There was statistical significance between patients who received referral to PCS and those who had a higher oral morphine equivalent daily dose (OMEDD) in the 24 hours before death, as well as the presence of a continuous subcutaneous infusion. Although the cause of this relationship is undetermined, it may represent the prescription patterns of the palliative care physicians during consultation or potentially higher symptom burden prompting referral. There was also a higher proportion of patients who received hydromorphone compared with other opioids, though the OMEDD was consistent with other published literature.
摘要：
■2019年冠状病毒病（COVID-19）大流行导致生命终结时复杂的身体和心理社会症状负担。在其他疾病状态下，专家姑息治疗投入的好处已经确立，然而,几乎没有证据表明，在死于COVID-19的患者中，这些服务的转诊模式。
这项回顾性审计调查了2022年在南澳大利亚一家四级医院（皇家阿德莱德医院）死于COVID-19的患者的转诊模式，以及人口统计学特征或COVID-19特定因素是否对这些患者是否接受专科姑息治疗服务（PCS）产生影响。第二个目标是确定患者生命最后24小时的处方模式，以及这是否受到转诊的影响。
■数据是从电子病历中获得的，并根据各种预测因素，使用二元逻辑回归分析转诊至PCS与不转诊。
■患者人口统计学或COVID-19特异性因素与转诊PCS相比没有显着差异。死亡前24小时接受转诊的患者与口服吗啡等效日剂量（OMEDD）较高的患者之间有统计学意义。以及持续皮下输注的存在。尽管这种关系的原因尚不确定，它可能代表了姑息治疗医师在会诊期间的处方模式,或提示转诊的潜在更高的症状负担.与其他阿片类药物相比，接受氢吗啡酮的患者比例也更高，尽管OMEDD与其他已发表的文献一致。
这项回顾性审计调查了2022年在南澳大利亚一家四级医院（皇家阿德莱德医院）死于COVID-19的患者的转诊模式，以及人口统计学特征或COVID-19特定因素是否对这些患者是否接受专科姑息治疗服务（PCS）产生影响。第二个目标是确定患者生命最后24小时的处方模式，以及这是否受到转诊的影响。
■数据是从电子病历中获得的，并根据各种预测因素，使用二元逻辑回归分析转诊至PCS与不转诊。
■患者人口统计学或COVID-19特异性因素与转诊PCS相比没有显着差异。死亡前24小时接受转诊的患者与口服吗啡等效日剂量（OMEDD）较高的患者之间有统计学意义。以及持续皮下输注的存在。尽管这种关系的原因尚不确定，它可能代表了姑息治疗医师在会诊期间的处方模式,或提示转诊的潜在更高的症状负担.与其他阿片类药物相比，接受氢吗啡酮的患者比例也更高，尽管OMEDD与其他已发表的文献一致。
