title: When and how should physicians determine the need for palliative and hospice care for patients with end-stage liver disease?: an experience in Taiwan.
abstract: We analyzed one case of end-stage liver disease and discussed whether the palliative care should be considered for this case. The medical record of a 56-year-old woman with alcoholic liver cirrhosis admitted to our hospital due to hypovolemic shock and esophageal varices (EV) was reviewed. The EV with active bleeding were arrested by panendoscopic intervention. However, repeat surgery revealed transmural laceration over the cardia, and immediate surgery and splenectomy were needed. The patient died postoperatively in the surgical intensive care unit due to bleeding tendency and hypovolemic shock. We suggest that palliative care and/or hospice care should have been considered for this patient before the crisis developed and that physicians require education about timely palliative and hospice care for patients with end-stage nonmalignant disease.
authors.affiliation: 1Department of Trauma, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Po-Chu
authors.initials: PC
authors.lastname: Lee
authors.forename: Chiao
authors.initials: C
authors.lastname: Lo
authors.forename: Wen-Je
authors.initials: WJ
authors.lastname: Ko
authors.forename: Sheng-Jean
authors.initials: SJ
authors.lastname: Huang
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
mesh_terms: D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D004932:Esophageal and Gastric Varices / Q000209:etiology / Q000601:surgery; D004945:Esophagoscopy; D017809:Fatal Outcome; D005260:Female; D017051:Hospice Care; D006801:Humans; D008875:Middle Aged; D010166:Palliative Care; D012769:Shock / Q000209:etiology; D013624:Taiwan
keywords: chronic liver disease; chronic renal disease; end-stage disease; hospice care; palliative care; surgery