Relationship between palliative care consultation service and end-of-life outcomes.
OBJECTIVE
Palliative care consultation service (PCCS) is currently utilized to provide care to terminal patients in Taiwan. However, there is little research on the relationship between PCCS and end-of-life outcomes. This study aimed to elucidate the association between PCCS and end-of-life outcomes in terminal cancer patients.


METHODS
Retrospective chart reviews of terminal cancer patients who consulted the PCCS of a medical center in Taiwan from January 2007 to December 2012 were performed. Data on 1369 patients were recorded, which included details of outcomes such as discharge from hospital, transfer to hospice ward, and death after PCCS termination. Other variables such as demographics, disease-related information, symptoms, and psychosocial needs were also evaluated. Logistic regression models were employed to estimate the adjusted odds ratios and related 95% confidence intervals.


RESULTS
The Eastern Cooperative Oncology Group performance status, timing of do-not-resuscitate (DNR) signature, constipation, and spiritual problems experienced by the patients were important predictors for terminal cancer patients who were discharged from the hospital or had expired at the time of PCCS termination. Age, gender, primary cancer diagnosis, timing of DNR signature, constipation, and other physical symptoms were the key predictors for patients who were transferred to the hospice ward or had expired.


CONCLUSIONS
This study confirms the outcomes of PCCS and highlights the important predictors for patients at PCCS termination. These factors can be targeted to improve and enhance the quality of PCCS rendered in the future.
Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan.
Li-Fen
LF
Wu
School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
Chi-Ming
CM
Chu
Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
Yu-Guang
YG
Chen
Division of Hematology and Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
Ching-Liang
CL
Ho
Department of Nursing, Tri-Service General Hospital, Taipei City, Taiwan. pshing2001@gmail.com.|School of Nursing, National Defense Medical Center, Taipei City, Taiwan. pshing2001@gmail.com.
Hsueh-Hsing
HH
Pan
D000328:Adult; D000368:Aged; D003248:Constipation; D005260:Female; D017051:Hospice Care / Q000379:methods*; D006738:Hospices; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010166:Palliative Care / Q000379:methods*; D012189:Retrospective Studies; D013624:Taiwan; D019452:Terminally Ill / Q000523:psychology*
End of life; Outcomes; Palliative care consultation service; Terminal cancer patients