Diferencias en pacientes oncológicos y no oncológicos ingresados en una unidad de cuidados paliativos de reciente creación en un hospital de tercer nivel en la Comunidad Valenciana (España)

Abstract

ObjectiveTo evaluate patient differences between palliative cancer and non-cancer patients admitted to the Unit of Palliative Care. Material and methodsA retrospective and analytical study of the palliative patients treated in the Unit of Palliative Care under the Department of Internal Medicine, Hospital General Universitario of Alicante between 1 June 2013 and 31 June 2014. Variables included were epidemiological (age, sex), clinical symptoms (fever, cachexia / anorexia, asthenia, nausea / vomiting, drowsiness, psychological symptoms, pain and dyspnoea), outcome and need for palliative sedation. ResultsOne hundred and forty-three patients out of the 1,599 (8.9%) admitted to the Section of Internal Medicine were studied in the Unit of Palliative Care. The median age of the patients was 83 years (interquartile range: 75-89) and the male: female ratio was 1.4. Sixty-four (44.7%) were palliative cancer patients and 79 (65.3%) were non-cancer palliative. Out of 79 non-cancer palliative patients: 38 (48.1%) were patients with irreversible progression of comorbidities, 33 (41.8%) patients with end-stage chronic disease and 8 (10.1%) elderly patients in the final stage of life. With regard to symptoms, the non-cancer palliative patients were more likely to experience dyspnoea (odds ratio [OR]: 4.65, 95% confidence interval [CI]:, 1.7-10 7) and less likely to experience pain (OR: 0.23; 95% CI: 0.09 to 0.54) and nausea /vomiting (p=.025). Symptoms were better controlled in the non- non- cancer palliative patients (OR: 2.03; 95% CI 1.0 to 4.10). Palliative sedation was administered to 23% of the patients, similar in both types of patients. ConclusionThe symptoms of palliative care were different in the non-cancer and cancer patients.