Palliative Volume Resuscitation in a Patient with Cancer and Hypercalcemia: Why Bother?

Ferraro, Kelly; Sanchez-Reilly, Sandra

doi:10.1089/jpm.2019.0343

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…By contrast, physicians prioritize resuscitation over comfort care in patients with more clinical uncertainty. While physicians must not avoid intensive treatments when reversibility appears possible, they should also balance medical procedures to ensure adequate comfort [ 51 ]. With repeated clinical assessments, promptly clarifying the goal of care may lead to a chance for better care.…”

Section: Discussionmentioning

confidence: 99%

Aggressiveness of care in the last days of life in the emergency department of a tertiary hospital in Korea

Kim

Lee

et al. 2022

BMC Palliat Care

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Background High-quality end-of-life (EOL) care requires both comfort care and the maintenance of dignity. However, delivering EOL in the emergency department (ED) is often challenging. Therefore, we aimed to investigate characteristics of EOL care for dying patients in the ED. Methods We conducted a retrospective cohort study of patients who died of disease in the ED at a tertiary hospital in Korea between January 2018 and December 2020. We examined medical care within the last 24 h of life and advance care planning (ACP) status. Results Of all 222 disease-related mortalities, 140 (63.1%) were men, while 141 (63.5%) had cancer. The median age was 74 years. As for critical care, 61 (27.5%) patients received cardiopulmonary resuscitation, while 80 (36.0%) received mechanical ventilation. The absence of serious illness (p = 0.011) and the lack of an advance statement (p < 0.001) were both independently associated with the receipt of more critical care. Only 70 (31.5%) patients received comfort care through opioids. Younger patients (< 75 years) (p = 0.002) and those who completed life-sustaining treatment legal forms (p = 0.001) received more comfort care. While EOL discussions were initiated in 150 (67.6%) cases, the palliative care team was involved only in 29 (13.1%). Conclusions Patients in the ED underwent more aggressive care and less comfort care in a state of imminent death. To ensure better EOL care, physicians should minimize redundant evaluations and promptly introduce ACP.

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Section: Discussionmentioning

confidence: 99%