Matches in SemOpenAlex for { <https://semopenalex.org/work/W2921568672> ?p ?o ?g. }
Showing items 1 to 78 of
78
with 100 items per page.
- W2921568672 abstract "Purpose In the UK, patients with severe heart failure suitable for heart transplantation may be managed with a life-sustaining LVAD as a bridge to transplant. Many will not undergo transplantation, either due to lack of donor organs or clinical deterioration rendering them no longer fit for surgery. These patients are at risk of LVAD-related complications and will die with their device in situ. The UK healthcare system and palliative care provision differs significantly with the US. We describe the end of life for this UK patient group. Methods Retrospective case note review of 40 deceased patients who underwent LVAD implantation between 2010 and 2016 at a single UK centre. Results Within this cohort, mean age at death was 57 years, with median interval between LVAD implantation and death of 18 months (range 6-76). This group were geographically diverse, only 12.5% lived close to the specialist centre. In 40% of cases, some advance care planning had been commenced, with a ‘Do Not Attempt Cardio Pulmonary Resuscitation’ decision documented. This cohort included no cases of elective LVAD deactivation; instead the LVAD was deactivated at the point of natural death. 45% received palliative care review (n=18). Death was described as sudden in 17 patients; this subgroup most commonly died at home (65%). Where dying was recognised and death expected (n=19), patients were highly likely to die in hospital (84%), but transfer to a local hospital close to home (5%) or a hospice (16%) was achieved for a minority. Overall, preferred place of death was documented for 12 patients and achieved in 10/12 cases. Challenges around practical management of the life-sustaining LVAD in the last hours of life, resulted in no expected deaths at home. Anticipatory SC PRN medications were prescribed for 68% and symptom assessment undertaken in 84% of cases. Conclusion The last days of life for patients in the UK with LVAD support, were commonly spent in hospital following active management of a LVAD-related complication. This is comparable with recent US data. There is scope for further improvement in recognition of dying and advance care planning given the possibility of sudden death. Early and routine palliative care input is recommended to improve quality of end of life care, including consideration of future care wishes and practical device management." @default.
- W2921568672 created "2019-03-22" @default.
- W2921568672 creator A5005189371 @default.
- W2921568672 creator A5067389851 @default.
- W2921568672 date "2019-04-01" @default.
- W2921568672 modified "2023-09-27" @default.
- W2921568672 title "Describing the End of Life Experience of Patients Supported with a Life-Sustaining Left Ventricular Assist Device (LVAD) as Bridge to Transplantation in a UK Centre" @default.
- W2921568672 doi "https://doi.org/10.1016/j.healun.2019.01.760" @default.
- W2921568672 hasPublicationYear "2019" @default.
- W2921568672 type Work @default.
- W2921568672 sameAs 2921568672 @default.
- W2921568672 citedByCount "0" @default.
- W2921568672 crossrefType "journal-article" @default.
- W2921568672 hasAuthorship W2921568672A5005189371 @default.
- W2921568672 hasAuthorship W2921568672A5067389851 @default.
- W2921568672 hasConcept C126322002 @default.
- W2921568672 hasConcept C141071460 @default.
- W2921568672 hasConcept C159110408 @default.
- W2921568672 hasConcept C167135981 @default.
- W2921568672 hasConcept C177713679 @default.
- W2921568672 hasConcept C194828623 @default.
- W2921568672 hasConcept C2777995714 @default.
- W2921568672 hasConcept C2778198053 @default.
- W2921568672 hasConcept C2778774980 @default.
- W2921568672 hasConcept C2778849806 @default.
- W2921568672 hasConcept C2779134260 @default.
- W2921568672 hasConcept C2779326848 @default.
- W2921568672 hasConcept C2780879335 @default.
- W2921568672 hasConcept C2911091166 @default.
- W2921568672 hasConcept C29374701 @default.
- W2921568672 hasConcept C2994186709 @default.
- W2921568672 hasConcept C71924100 @default.
- W2921568672 hasConcept C72563966 @default.
- W2921568672 hasConceptScore W2921568672C126322002 @default.
- W2921568672 hasConceptScore W2921568672C141071460 @default.
- W2921568672 hasConceptScore W2921568672C159110408 @default.
- W2921568672 hasConceptScore W2921568672C167135981 @default.
- W2921568672 hasConceptScore W2921568672C177713679 @default.
- W2921568672 hasConceptScore W2921568672C194828623 @default.
- W2921568672 hasConceptScore W2921568672C2777995714 @default.
- W2921568672 hasConceptScore W2921568672C2778198053 @default.
- W2921568672 hasConceptScore W2921568672C2778774980 @default.
- W2921568672 hasConceptScore W2921568672C2778849806 @default.
- W2921568672 hasConceptScore W2921568672C2779134260 @default.
- W2921568672 hasConceptScore W2921568672C2779326848 @default.
- W2921568672 hasConceptScore W2921568672C2780879335 @default.
- W2921568672 hasConceptScore W2921568672C2911091166 @default.
- W2921568672 hasConceptScore W2921568672C29374701 @default.
- W2921568672 hasConceptScore W2921568672C2994186709 @default.
- W2921568672 hasConceptScore W2921568672C71924100 @default.
- W2921568672 hasConceptScore W2921568672C72563966 @default.
- W2921568672 hasLocation W29215686721 @default.
- W2921568672 hasOpenAccess W2921568672 @default.
- W2921568672 hasPrimaryLocation W29215686721 @default.
- W2921568672 hasRelatedWork W2018024689 @default.
- W2921568672 hasRelatedWork W2100107549 @default.
- W2921568672 hasRelatedWork W2112404476 @default.
- W2921568672 hasRelatedWork W2122211023 @default.
- W2921568672 hasRelatedWork W2186696823 @default.
- W2921568672 hasRelatedWork W2195541649 @default.
- W2921568672 hasRelatedWork W2336505042 @default.
- W2921568672 hasRelatedWork W2570316664 @default.
- W2921568672 hasRelatedWork W2736272666 @default.
- W2921568672 hasRelatedWork W2801127296 @default.
- W2921568672 hasRelatedWork W2890929025 @default.
- W2921568672 hasRelatedWork W2948446234 @default.
- W2921568672 hasRelatedWork W2982426915 @default.
- W2921568672 hasRelatedWork W3010554632 @default.
- W2921568672 hasRelatedWork W3014188746 @default.
- W2921568672 hasRelatedWork W3092996369 @default.
- W2921568672 hasRelatedWork W3137331284 @default.
- W2921568672 hasRelatedWork W3138060805 @default.
- W2921568672 hasRelatedWork W3139468300 @default.
- W2921568672 hasRelatedWork W3162167091 @default.
- W2921568672 isParatext "false" @default.
- W2921568672 isRetracted "false" @default.
- W2921568672 magId "2921568672" @default.
- W2921568672 workType "article" @default.