[Dying in the hospital from an end-stage non-oncologic disease: a decision making analysis].
OBJECTIVE
The aim of the study was to evaluate palliative decision-making in non- oncological patients who died in an acute care hospital.


METHODS
293 patients > 64 years old were analyzed. These patients suffered from dementia (46%), end-stage congestive heart failure (31%) and end-stage chronic obstructive pulmonary disease (23%). We evaluated written information about: do not resuscitate (DNR) orders, graduation of therapeutic decisions, information provided to relatives about prognosis, total withdrawal of other drug therapy and provision of terminal care.


RESULTS
DNR orders were specified in 37% of cases, graduation of therapeutic decisions in 18% and knowledge of the prognosis by relatives in 57%. Drug withdrawal was carried out in 56% and palliative care in 65% patients.


CONCLUSIONS
Identification and provision of palliative care, in an acute care hospital, of elderly patients at their last admission prior to death because of non-oncological end-stage diseases must be improved.
Formiga
Francesc
F
UFISS de Geriatría. Servicio de Medicina Interna. Hospital Universitari de Bellvitge. L'Hospitalet de Llobregat. Barcelona, Spain. fformiga@csub.scs.es
Vivanco
Victoria
V
Cuapio
Yazz
Y
Porta
Josep
J
Gómez-Batiste
Xavier
X
Pujol
Ramón
R
D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D003657:Decision Making; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007297:Inpatients; D008297:Male; D010166:Palliative Care / Q000706:statistics & numerical data*; D013727:Terminal Care / Q000706:statistics & numerical data; D019452:Terminally Ill