title: Impact of palliative care unit admission on symptom control evaluated by the edmonton symptom assessment system.
abstract: The aim of the present study was to evaluate the impact of palliative care on patients' symptoms, using the Edmonton Symptom Assessment System (ESAS) to measure symptom intensity at the time of admission and variations registered during the first 7 days' hospitalization. Three hundred fourteen patients were admitted to the unit during its first year of activity. Of these, 162 patients (51.6%) completed, 62 (19.7%) partially completed, and 90 (28.7%) did not complete the ESAS. The mean (+/-SD) value of the Symptom Distress Score (SDS) (sum of the values of the different symptoms) for the 162 evaluable patients on Day 1 was 33.93 (+/-16.24). On Day 7 the mean was 28.14 (+/-15.11) (ANOVA for repeated measurements, P < 0.0001). ESAS values for patients with moderate-severe symptom intensity (average values Day 1-Day 7 and P value, ANOVA for repeated measurements) were as follows: pain (7.12-4.23, P < 0.0001), fatigue (7.46-5.68, P < 0.0001), nausea (7.12-1.96, P < 0.0001), depression (7.26-5.28, P < 0.0001), anxiety (7.13-5.14, P < 0.0001), drowsiness (7.42-6.40, P = 0.002), anorexia (7.33-4.33, P < 0.0001), well-being (6.83-3.85, P < 0.0001), and dyspnea (7.08-3.86, P < 0.0001). These data seem to indicate that the patients who benefit most from inpatient palliative care are those with the most complex symptomatology.
authors.affiliation: Palliative Care Unit, Department of Medical Oncology, Forlimpopoli Hospital, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Modonesi
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.forename: Marco
authors.initials: M
authors.lastname: Maltoni
authors.forename: Stefania
authors.initials: S
authors.lastname: Derni
authors.forename: Laura
authors.initials: L
authors.lastname: Fabbri
authors.forename: Francesca
authors.initials: F
authors.lastname: Martini
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Sansoni
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D010146:Pain / Q000453:epidemiology; D059408:Pain Management; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D015995:Prevalence; D015397:Program Evaluation; D011446:Prospective Studies; D013315:Stress, Psychological / Q000453:epidemiology / Q000628:therapy*