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Survival and factors affecting the survival of older adult patients in palliative care.

Authors
  • Yuruyen, Mehmet1
  • Polat, Ozlem2
  • Denizli, Betul Ondes3
  • Cirak, Musa4
  • Polat, Hakan5
  • 1 Department of Internal Medicine, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Palliative Care Center, Istanbul, Turkey. , (Turkey)
  • 2 Department of Family Medicine, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Palliative Care Center, 31147, Bakırkoy, Istanbul, Turkey. [email protected]. , (Turkey)
  • 3 Department of Family Medicine, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Palliative Care Center, 31147, Bakırkoy, Istanbul, Turkey. , (Turkey)
  • 4 Department of Neurosurgery, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. , (Turkey)
  • 5 Department of Urology, University of Health Sciences, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. , (Turkey)
Type
Published Article
Journal
Irish journal of medical science
Publication Date
Aug 01, 2023
Volume
192
Issue
4
Pages
1561–1567
Identifiers
DOI: 10.1007/s11845-022-03186-5
PMID: 36261749
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Investigate the survival and risk factors that affect the survival of aged patients in a palliative care center (PCC). A total of 180 inpatients (aged ≥ 65 years) who were admitted to a PCC from January 2018 to March 2020 were included. Information regarding patients' demographic characteristics, chronic diseases, length of hospital stay, nutrition provided at the first hospital stay, pressure wound, pain, and laboratory results were evaluated. The patients 50% were women (n = 90). The mean age, mean comorbidity, and mean follow-up duration was 77.6 years, 3.4, and 115 days (median: 29 days), respectively. The mean NRS2002 score of patients was 4.0 ± 1.0 and the risk of malnutrition was 93%. The mortality rate of the patients was 91.7%. The life expectancy of patients without malignancy was higher than those with malignancy (p < 0.001). Enteral nutrition (EN) via percutaneous endoscopic gastrostomy (PEG) was associated with up to two-fold increase in the survival rates of patients with PCC (p = 0.049, HR: 2.029). High neutrophil/lymphocyte ratio (p = 0.002, HR: 1.017) and high ferritin (p = 0.001, HR: 1.000) and C-reactive protein (CRP) levels (p < 0.001, HR: 1.006) were adverse risk factors affecting life expectancy. Malignity reduced the survival rate of aged patients with PCC by 40% (p = 0.008). EN via PEG was found to be a positive factor affecting survival rates of older adult patients in palliative care, whereas malignity, high neutrophil/lymphocyte ratio, high CRP and ferritin levels, and prolonged hospital stays were negative risk factors. © 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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