[Palliative care for patients with heart failure].
OBJECTIVE
Heart failure is a common disease and its progression to end-stage heart failure is responsible of high mortality. The aim of this retrospective study was to assess the access to integrated palliative care to the usual management, 6 months prior to their death, and especially during the last hospitalization.


METHODS
A retrospective study was performed in patients who died of heart failure in 2009 in two hospitals. The analysis was performed on 20 cases of each institution. The records of consecutive patients were included in an anti-chronological order from 31st December 2009.


RESULTS
For their last hospitalization, 37 patients (93%) were hospitalized in emergency. Within 3 days prior to death, the most frequent symptoms were dyspnea (n=33, 82%), and pain (n=30, 75%). Therapeutic most frequently used were oxygen (n=31, 77%) and analgesics (n=30, 75%). No patient was seen by a psychologist. The decision to limit treatment for comfort care was reported for 24 patients (60%) and the median of the average time between the decision and death was 2 days (Q1-Q3, 1-5 days).


CONCLUSIONS
Patients with terminal heart failure have many symptoms often requiring multidisciplinary care. This type of study relating practices shows that there is still a lot to do to integrate palliative care in the usual management of patients with heart failure.
Équipe mobile de soins palliatifs, Hôtel-Dieu, centre hospitalier de Pontchaillou, 35000 Rennes, France.
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Texier
Centre de soins palliatifs Pavillon 1K, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, États-Unis; Laboratoire EA 4129, santé-individu-société, université Lyon-1, 69008 Lyon, France. Electronic address: wadihrhondali@gmail.com.
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Rhondali
Centre hospitalier William-Morey, 71100 Chalon-sur-Saône, France; Fondation Hôtel-Dieu du Creusot, 71200 Le Creusot, France.
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Meunier-Lafay
Centre hospitalier William-Morey, 71100 Chalon-sur-Saône, France.
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Dellinger
Fondation Hôtel-Dieu du Creusot, 71200 Le Creusot, France.
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Gérard
Équipe mobile de soins palliatifs, Hôtel-Dieu, centre hospitalier de Pontchaillou, 35000 Rennes, France.
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Morel
Centre de soins palliatifs Pavillon 1K, centre hospitalier Lyon-Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
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Filbet
D000369:Aged, 80 and over; D005260:Female; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D010166:Palliative Care; D012189:Retrospective Studies
Insuffisance cardiaque terminale; Multidisciplinaire; Multidisciplinary; Palliative care; Severe heart failure; Soins palliatifs; Symptoms; Symptômes