[The final week of life in an acute care hospital: review of 401 consecutive patients].
BACKGROUND
because of population ageing and sociocultural changes related to death, increasing the numbers of patients are dying in hospitals.


OBJECTIVE
to analyze patient characteristics and end-of-life care in the final week of life in patients dying in an acute-care hospital.


METHODS
all patients older than 18 years old who died in the hospital over a 1-year period were analyzed. Patients dying in intensive care and emergency units were excluded. The following variables were evaluated: demographic data, main illness, cause of admission, comorbidity, terminal illness, medication, delay in beginning palliative sedation, use of devices, adverse events, and do not attempt resuscitation orders.


RESULTS
a total of 401 patients (mean age: 78 +/- 11 years) with numerous comorbidities were evaluated. Of these, 348 patients (87%) were considered to be terminal. The reason for admission was related to the main disease in 207 patients (52%). Terminal sedation was applied in 311 patients (78%), and informed consent from the relatives was documented in 294 patients (73%). Intervention by on-call physician was required to control symptom aggravation in 214 patients (55%). Active medication was maintained in addition to sedation in 145 patients (36%). Complementary examinations were performed in 109 patients (40%), but did not modify prognosis.


CONCLUSIONS
reasonable therapeutics objectives relating to the patient's situation and guidelines to improve quality of life at the end of life should be established.
Servicio de Medicina Interna. Hospital de Barcelona. Barcelona. España. 16385avs@comb.es
Anna
A
Vilà Santasuana
Nuria
N
Celorrio Jiménez
Xavier
X
Sanz Salvador
Joaquín
J
Martínez Montauti
Enrique
E
Díez-Cascón Menéndez
Carme
C
Puig Rossell
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D013727:Terminal Care
Ultima semana de vida en un hospital de agudos: revisión de 401 pacientes consecutivos.