Beyond hospice: the burden of palliative care needs in hospitals and long-term care facilities. A nationwide multicenter study.
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Ошибки и ограничения
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Onder Graziano, Zucchelli Alberto, Malara Alba, Borselli Gilda, Iurlaro Angela, Bauco Claudia, Bianchetti Angelo, Bracco Christian, Cafariello Carmine, Cartesio Stefania, Cipriani Luca, Deias Giulia, De Leo Diego, Durante Elisa, Fortini Gianpaolo, Gilioli Fabio, Giordano Stefania, Horn Guido, Macaluso Myriam, Palleschi Lorenzo, Pinardi Elena, Santini Claudio, Scaccabarozzi Gianlorenzo, Tarquini Roberto, Torrini Monica, Varratta Edoardo, Veronese Nicola, Zazzara Maria Beatrice, Leosco Dario, Bellelli Giuseppe, Palliative Care Day 2025 Working Group
Аннотация
METHODS: We conducted a national cross-sectional point-prevalence study. Adults aged ≥ 18 years hospitalized in participating wards or residing in LTCF were eligible. NECPAL 4.0 tool was used to identify patients and residents with palliative care needs. Additional indicators included functional and nutritional decline, repeated hospitalizations, dysphagia, pressure ulcers, delirium, and pain.
RESULTS: A total of 5,389 participants were included (3,303 hospital patients, median age 81 years; 2,086 LTCF residents, median age 86 years) from 235 facilities. Overall, 58.3% of hospitalized patients and 48.1% of LTCF residents had a positive NECPAL assessment. Prevalence was higher among patients with cancer (77.2% in hospital; 61.5% in LTCF), but remained substantial among those without cancer (50.8% in hospital; 46.8% in LTCF). Functional decline (56.2% hospital; 48.7% LTCF), nutritional decline (36.6%; 23.9%), dysphagia (17.6%; 28.8%), delirium (19.2%; 36.4%), and moderate-to-severe pain (25.9%; 20.3%) were common across settings.
CONCLUSION: Palliative care needs are highly prevalent among hospitalized patients and LTCF residents and are not limited to oncology. These findings support systematic screening and integration of a needs-based palliative care approach within hospital and long-term care systems.