Clinical outcomes in terminally ill patients admitted to hospice care: Diagnostic and therapeutic interventions

This study's aim was to determine the impact of medical technologies on pat ient comfort and survival time, through retrospective review of the clinica l course, symptom profile, and illness trajectory in 102 consecutive patien ts (50 males and 52 females), and of diagnostic and therapeutic interventio ns delivered to them. The average age of males was 72.3 years and of female s 73.1 years. Ninety-four patients were admitted for palliation of symptoms due to malignant disease and eight other patients for non-malignant diseas es. The median survival time was 12 days. On admission, higher univariate h azard risks for survival were significantly associated with male gender, me tastatic disease, and dyspnea. Higher adjusted Charlson comorbidity scores were associated with significantly decreased survival time, while de novo s ymptoms and diagnostic interventions were associated with lower univariate risk rates and increased survival times. Palliative therapeutic interventio ns were not significantly associated with increased patient survival. A mul tivariate analysis showed that pain, dyspnea, immobility, and adjusted Char lson comorbidity scores were independent risks for shorter patient survival times. Diagnostic interventions were significant for increased patient sur vival. No requests for euthanasia had been recorded, which may, in part, re flect the significant family support most of these patients had received.