Clinical findings of a palliative care consultation team at a comprehensive cancer center.
BACKGROUND
Palliative care consultation teams (PCCTs) are being established in cancer centers for the management of patients' physical and psychosocial distress. As clinical findings of these teams have been reported infrequently, we aim to describe the experience of our high-volume inpatient PCCT.


METHODS
We obtained clinical and demographic data on patients referred to our PCCT from the palliative care departmental database from September 1, 2003, to August 31, 2004.


RESULTS
In 1 year, 1067 consultations took place for 922 hospitalized patients. The patients' mean age was 60 (range, 3-98) years. The most common cancers were thoracic/head and neck, gastrointestinal, genitourinary, gynecologic cancers, and lymphoma. Thirty-four percent of the patients were transferred to the inpatient palliative care unit, while the remainder were followed by the PCCT as consultants. The main problems requiring PCCT consultation were pain (56%), delirium (34%), dyspnea (25%), fatigue (14%), and end-of-life psychosocial (EOL) issues (12%). Twenty-four percent of patients died during the hospitalization. Death during the hospitalization was more common in patients with delirium, dyspnea, and EOL issues and less likely in patients referred to the PCCT for pain or depression. Constipation was more common in patients with solid tumors, whereas EOL issues were more common in patients with hematologic malignancies. Of the patients who were able to be discharged, 56% went home, 37% to hospice, and 7% elsewhere.


CONCLUSIONS
These results provide insight into the demand and utility of this service for those considering the establishment of a PCCT.
Dhillon
Navneet
N
Department of Palliative Care and Rehabilitation, University of Texas M.D Anderson Cancer Center, Houston, Texas, USA. nvdhillon@gmail.com
Kopetz
Scott
S
Pei
Be Lian
BL
Fabbro
Egidio Del
ED
Zhang
Tao
T
Bruera
Eduardo
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003191:Comprehensive Health Care / Q000458:organization & administration*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*; D010348:Patient Care Team; D012017:Referral and Consultation; D012189:Retrospective Studies