title: Palliative care needs of patients with neurologic or neurosurgical conditions.
abstract: OBJECTIVE
  Many patients with non-cancer diagnoses utilize palliative services. There is little data on the palliative care needs of patients with neurologic and neurosurgical disorders.
  
  
  METHODS
  Retrospective chart review. Log sheets which contain all patients seen between January 2004 and 2007 by palliative medicine (PM) were reviewed. Patients with neurologic or neurosurgical disorders were identified and their in-patient charts and electronic records reviewed. Patients with cancer were excluded.
  
  
  RESULTS
  A total of 1429 cancer patients were seen by PM. Neurologic or neurosurgical diseases were the second most common in patients seen by the PM service, in 177 cases. Forty-seven patients were excluded. Complete data was collected on 129 patients. Mean age was 70. Seventy-one (55%) were female. The most common neurologic diagnosis was ischemic stroke in 33 (26%). Seventy-five (58%) had symptoms recorded. Reasons for PM consultation included 'comfort measures' in 40 (39%) and 'hospice candidacy' in 38 (37%). The most common recommendation made by the PM service was morphine in 44 (42%). Sixty-three (49%) were deemed hospice appropriate.
  
  
  CONCLUSIONS
  Our findings support the need for PM services for patients with various neurologic and neurosurgical disorders. Understanding these needs will allow for the tailoring of palliative care services to such patients.
authors.affiliation: Department of Neurology, Cleveland Clinic, Cleveland, OH 44195, USA. chahinl@ccf.org
authors.forename: L M
authors.initials: LM
authors.lastname: Chahine
authors.forename: B
authors.initials: B
authors.lastname: Malik
authors.forename: M
authors.initials: M
authors.lastname: Davis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing; D002908:Chronic Disease / Q000451:nursing; D005260:Female; D006801:Humans; D016224:Living Wills / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000451:nursing*; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000451:nursing; D009462:Neurology / Q000706:statistics & numerical data / Q000639:trends; D009493:Neurosurgery / Q000706:statistics & numerical data / Q000639:trends; D010166:Palliative Care / Q000379:methods / Q000592:standards*; D010343:Patient Admission / Q000592:standards / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000706:statistics & numerical data / Q000639:trends; D011182:Postoperative Care / Q000379:methods / Q000592:standards; D012017:Referral and Consultation / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D012944:Social Support