Characterization of patients with lung neoplasm referred and admitted to palliative care teams and the effectiveness of symptomatic control

• Autor(a) principal: Murinello, Nicole
• Data de Publicação: 2018
• Outros Autores: Capelas, Manuel Luís
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.34632/cadernosdesaude.2018.5289

Introduction: Lung neoplasm (LN) is considered a global epidemic due to its incidence and mortality. Most patients are diagnosed at an advanced stage and already symptomatic. The relevance of this pathology justifies an assessment of patients and needs and palliative care (PC) teams’ responsiveness. Aim: Characterize patients with LN admitted to PC teams in national territory during 2017. Evaluate symptomatic control effectiveness.  Materials and Methods: Epidemiological, descriptive and analytical study. An accidental sample was obtained and simple statistical measures, as well as non-parametric tests, were used (Mann-Whitney, Kruskal-Wallis and Spearman correlation), with a level of significance p < 0.05. Normality analysis was done by Shapiro-Wilk test and survival estimate by Kaplan-Meier curves. The FACIT-PAL instrument was used for symptomatic evaluation. Results: 38 patients with LN were admitted in a total of 7 participating PC teams, with a mean age of 71.4 years, 71.1% male and 65.8% with metastatic disease. 60.5% were admitted to community palliative care teams. The median distance between place of residence and admission service was 6.6 Km, with a significant difference according to the type of team (p <0.001). The median waiting time for admission was 2 days with a significant difference according to the type of team (p <0.001). The mortality rate was 63.2%, with a median survival (SV) of 17 days. The need for symptomatic control was the main reason for referral. In 71.11% there was a record of symptomatic assessment at 48-72h of admission, but only in 21.1% using the standardized assessment instrument. There was no significant difference in SV depending on the stage of the disease (p = 0.501) and there was no significant correlation between waiting time for admission and symptom score (p = 0.217) or SV (p = 0.668). Conclusion: Sociodemographic and clinical characteristics of this sample are similar to what is reported in literature. The majority of patients admitted presented as metastatic stage with a median survival after admission less than 1 month, which may traduce a late referral to PC teams. In this study, we noticed a low participation of PC teams and we did not have access to the total number of referred. Therefore, this sample study is not representative of reality. There were also biases in symptomatic evaluation according to FACIT-PAL scale, compromising symptomatic control effectiveness analysis.