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• W2886761096 abstract "Describir los cuidados proporcionados al final de la vida en los pacientes fallecidos en servicios de medicina interna. Estudio observacional, transversal, retrospectivo y multicéntrico de auditoría clínica. Cada hospital incluyó los 10 primeros pacientes fallecidos en el servicio de medicina interna a partir del 1 de diciembre de 2015. Se recogieron datos demográficos, clínicos y de circunstancias y cuidados en la muerte. Se incluyeron 1.447 pacientes, con una mediana de edad de 84 años. Eran pluripatológicos 1.065 (74,3%), estaban en situación terminal 751 (51,9%) y tenían cáncer 248 (17,1%) pacientes. En los pacientes terminales se estableció una orden de no reanimación en 539 (73,3%) y se realizó sedación paliativa en 422 (57,4%). No se registró si se proporcionaron cuidados psicológicos, religiosos o de atención al duelo en el 32, 64,8 y 44,1%, respectivamente, de los pacientes terminales. Los pacientes con cáncer con más frecuencia eran competentes para la toma de decisiones (54,4% vs. 15,5%; p < 0,001), conocían su pronóstico (42,6% vs. 8,6%; p < 0,001), recibieron cuidados psicológicos (24,9% vs. 8,6%; p < 0,001), fallecieron en una habitación individual (64,6% vs. 44,4%; p < 0,001) y estuvieron acompañados (81,9% vs. 71,9%; p = 0,003). Además, sus familiares recibieron con más frecuencia atención al duelo (15,6% vs. 8,2%; p = 0,002). Hay un registro insuficiente en las historias clínicas de los cuidados al final de la vida. Hay diferencias en los cuidados proporcionados a los pacientes con y sin cáncer. To describe the care provided at the end of life for patients who die in internal medicine departments. An observational, cross-sectional, retrospective multicentre, clinical audit study was conducted where each hospital included the first 10 patients who died in the internal medicine department starting on December 1, 2015. We collected demographic and clinical data and information regarding the circumstances and care at the time of death. The study included 1,447 patients with a median age of 84 years. Of these, 1,065 (74.3%) were polypathological, 751 (51.9%) were terminal and 248 (17.1%) had cancer. For the terminal patients, do-not-resuscitate orders were established for 539 (73.3%), and palliative sedation was performed for 422 (57.4%). There was no record as to whether psychological, religious or grief care was provided in 32%, 64.8% and 44.1% of the terminal patients, respectively. The patients with cancer were more often competent to make decisions (54.4% vs. 15.5%; P < .001), knew their prognosis (42.6% vs. 8.6%; P < .001), received psychological care (24.9% vs. 8.6%; P < .001), died in an individual room (64.6% vs. 44.4%; P < .001) and were accompanied (81.9% vs. 71.9%; P = .003). Their relatives also more frequently received grief care (15.6% vs. 8.2%; P = .002). There is insufficient recording in the medical history as to the end-of-life care. There are differences in the care provided to patients with cancer and to those without cancer." @default.
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• W2886761096 date "2019-04-01" @default.
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• W2886761096 title "Cuidados en los últimos días de vida en los pacientes hospitalizados en medicina interna" @default.
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• W2886761096 doi "https://doi.org/10.1016/j.rce.2018.06.010" @default.
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