Acute inpatient palliative medicine in a cancer center: clinical problems and medical interventions--a prospective study.
The clinical characteristics and medical interventions of the 100 consecutive cancer admissions to the acute care inpatient palliative medicine unit at the Cleveland Clinic for 2 months are described. Median age was 62 years (range, 31 to 92 years). The male-female ratio was 1:1. Most admissions were referred by hematology-oncology and had prior antineoplastic therapy. Reasons for admission were symptom control and cancer-related complications. Patients underwent invasive diagnostic and therapeutic procedures, hydration, transfusions, radiation, or chemotherapy, or a combination, during their admission. Most were discharged home with hospice care or had outpatient clinic follow-up. The mortality rate was 20%. Aggressive multidisciplinary management of symptoms, disease complications, comorbid conditions, and psychosocial problems were provided. Palliative medicine physicians provided continuity of care in the outpatient clinic and at home. An acute inpatient palliative medicine unit within a tertiary level medical center has a definable and important role in comprehensive cancer care.
Lagman
Ruth
R
The Harry R. Horvitz Center for Palliative Medicine, The Cleveland Clinic Taussig Cancer Center, Cleveland, OH 44195, USA.
Rivera
Nilo
N
Walsh
Declan
D
LeGrand
Susan
S
Davis
Mellar P
MP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003266:Continuity of Patient Care / Q000458:organization & administration*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000628:therapy*; D009820:Ohio; D016522:Oncology Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D009936:Organizational Innovation; D009937:Organizational Objectives; D010166:Palliative Care / Q000458:organization & administration* / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies