International journal of palliative nursing · 2026
Goals of care and advance directives: A 1-year retrospective analysis of a tertiary centre in Saudi Arabia.
СтатьяНазвание и аннотация: Перевод в очереди
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Callaghan Steven, Sadler Kim, Abudari Gassan, Alhassan Kholoud, Almutairi Muneerah, Evangelista Ruth, Sroor Mahmoud, Placido Goncalo, Bacalso Lemon, AlGhamdi Mohammed, Albayjan Bashayer, Shaltoot Lubna, Alomari Reema, Azuny Mohammed, Alsubaie Amjad
Аннотация
BACKGROUND: Despite its limited therapeutic value, high costs and the fact that it can compromise a patient's quality of life, aggressive care continues to be provided at the end of life. It has been associated with a significant symptom burden for patients, a greater use of healthcare resources, delay in accessing palliative care programmes and personal/family and healthcare costs.
AIM: To investigate sociodemographic, clinical and community healthcare service factors associated with aggressive end-of-life care across malignant and non-malignant conditions.
METHOD: A 1-year retrospective analysis was conducted in a tertiary care centre in Saudi Arabia. All deaths of adult patients that occurred between 1 January, 2023 and 1 January, 2024, were included. Data were retrieved from medical charts, including sociodemographics, medical history, invasive medical interventions and use of healthcare services in the last 3 months of life.
RESULTS: The study included 590 adults (mean age 59.6 years; 52.2% male), with 62% diagnosed with malignancy. The majority (71%) had one or more chronic comorbidities. In their last 90 days, 48.6% were admitted to the intensive care unit. Advance directives were present for only half of the patients included in this study. Non-malignant patients received significantly more aggressive end-of-life care, including intubation and cardiopulmonary resuscitation. Palliative care referrals were low overall (48.1%), but higher in cases of malignancy (70.5%). Patients with involvement in a palliative care team showed a lower symptom burden and less aggressive treatment.
CONCLUSIONS: These findings suggest unequal access to end-of-life advocates for earlier palliative care referral, which could reduce aggressive treatments, especially for younger patients with non-malignant diseases. Non-cancer referral rates were low, highlighting a need for further collaboration and integration with palliative care services.
AIM: To investigate sociodemographic, clinical and community healthcare service factors associated with aggressive end-of-life care across malignant and non-malignant conditions.
METHOD: A 1-year retrospective analysis was conducted in a tertiary care centre in Saudi Arabia. All deaths of adult patients that occurred between 1 January, 2023 and 1 January, 2024, were included. Data were retrieved from medical charts, including sociodemographics, medical history, invasive medical interventions and use of healthcare services in the last 3 months of life.
RESULTS: The study included 590 adults (mean age 59.6 years; 52.2% male), with 62% diagnosed with malignancy. The majority (71%) had one or more chronic comorbidities. In their last 90 days, 48.6% were admitted to the intensive care unit. Advance directives were present for only half of the patients included in this study. Non-malignant patients received significantly more aggressive end-of-life care, including intubation and cardiopulmonary resuscitation. Palliative care referrals were low overall (48.1%), but higher in cases of malignancy (70.5%). Patients with involvement in a palliative care team showed a lower symptom burden and less aggressive treatment.
CONCLUSIONS: These findings suggest unequal access to end-of-life advocates for earlier palliative care referral, which could reduce aggressive treatments, especially for younger patients with non-malignant diseases. Non-cancer referral rates were low, highlighting a need for further collaboration and integration with palliative care services.