Aggressiveness of cancer-care near the end-of-life in Korea
Aggressiveness of cancer-care near the end-of-life in Korea
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DOI：
10.1093/jjco/hyn031
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发表时间：
2008-05-01
影响因子：
2.4
通讯作者：
Heo, Dae Seog
中科院分区：
文献类型：
--
作者：
Keam, Bhumsuk;Oh, Do-Youn;Heo, Dae Seog
目的：本研究的目的是探讨韩国癌症患者的化疗和护理的适当性在接近尾声的life.Methods：我们设计了一个回顾性队列组成的诊断为转移性癌症的患者，谁接受姑息性化疗在首尔国立大学医院于2002年。298例死于癌症的患者进行了评估，他们收到的癌症护理，包括chemotherapy.Results的适当性：化疗的中位持续时间为6.02个月，中位总生存期为8.67个月。末次化疗至死亡的中位时间为2.02个月。在298例患者中，50.3%在生命的最后2个月内接受化疗。此外，17例（5.7%）患者在接受化疗后2周内死亡。在生命的最后几个月里，超过一次访问急诊室（ER）的比例为33.6%，在诊断出癌症后，ER访问的平均次数为1.72。只有9.1%的患者被转介到临终关怀咨询服务，只有11.7%的患者同意书面DNR。结论：在死于癌症的患者中，发现有显着比例已接受化疗，直到生命的尽头，并已访问ER。临终关怀转介和有关DNR的讨论在韩国的生命末期没有很好地进行。
Objective: The aim of this study was to examine the appropriateness of chemotherapy and care in Korean cancer patients near the end-of-life.Methods: We designed a retrospective cohort composed of patients diagnosed as having metastatic cancer and who received palliative chemotherapy at Seoul National University Hospital in 2002. Two hundred and ninety-eight patients who died of cancer were evaluated in terms of the appropriateness of the cancer-care they received, including chemotherapy.Results: Median duration of chemotherapy was 6.02 months compared with 8.67 months for median overall survival. The median period between last chemotherapy and death was 2.02 months. Of the 298 patients, 50.3% received chemotherapy during the last 2 months of life. Furthermore, 17 patients (5.7%) died within 2 weeks after receiving chemotherapy. The proportion who visited an emergency room (ER) more than once during the last months of life was 33.6%, and the average number of ER visits after a diagnosis of cancer was 1.72. Only 9.1% of patients were referred to a hospice consultation service and only 11.7% of patients agreed with written DNR.Conclusions: Among patients who died of cancer, significant proportions were found to have received chemotherapy up to the end-of-life and to have visited ERs. Hospice referrals and discussions about DNR were not conducted well during the end-of-life period in Korea.