An evaluation of nutrition support for terminal cancer patients at teaching hospitals in Korea.
OBJECTIVE
We wanted to analyze the use of nutrition support for terminal cancer patients, the effect of discussing withdrawal of nutrition support and do-not-resuscitate (DNR) consent on the use of intravenous nutrition during the patient's last week of life and at the time of death.


METHODS
The study involved 362 patients with terminal cancer from four teaching hospitals, and they all died between January 1 2003 and December 31 2005. The basic demographic data, the use of intravenous nutrition during the patient's last week of life and at death, discussion of terminal nutrition withdrawal and DNR consent were evaluated.


RESULTS
In the week before death, the patients received artificial nutrition such as total parenteral nutrition (31%), intravenous albumin infusion (25%), and feeding tube placements (9%). A discussion concerning withdrawal of nutrition support was limited to 25 (7%) patients. DNR consent was obtained from 294 (81%) patients. None of the patients were directly involved in any of these decisions. The discussion about withdrawal of terminal nutrition and DNR consent with the patient's surrogates did not have any effect on reducing the use of parenteral nutrition.


CONCLUSIONS
The majority of patients dying of terminal cancer were still given potentially futile nutritional support. Modern clinical guidelines and ethical education about nutritional support at the end of life care is urgently needed in Korean medical practice to provide proper administration of terminal nutrition for end of life care.
Kim
Do Yeun
DY
Department of Internal Medicine, College of Medicine, Dongguk University Hospital, Goyang, Korea.
Lee
Sang Min
SM
Lee
Kyoung Eun
KE
Lee
Hye Ran
HR
Kim
Jee Hyun
JH
Lee
Keun-Wook
KW
Lee
Jong Seok
JS
Lee
Soon Nam
SN