Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Prediction of Patient Discharge Status Based on Indicators on Admission

입원 초기 지표를 통한 호스피스 환자의 퇴원 형태 예측

  • Chung, Sung-In (Department of Family Medicine, Pusan National University Hospital) ;
  • Lee, Seung Hun (Department of Family Medicine, Pusan National University Hospital) ;
  • Kim, Yun-Jin (Department of Family Medicine, Pusan National University Hospital) ;
  • Lee, Sang-Yeoup (Department of Medical Education, Pusan National University School of Medicine) ;
  • Lee, Jeong-Gyu (Department of Family Medicine, Pusan National University Hospital) ;
  • Yi, Yu-Hyeon (Department of Family Medicine, Pusan National University Hospital) ;
  • Cho, Young-Hye (Department of Family Medicine, Pusan National University School of Medicine) ;
  • Tak, Young-Jin (Department of Family Medicine, Pusan National University Hospital) ;
  • Hwang, Hye-Rim (Department of Family Medicine, Pusan National University Hospital) ;
  • Park, Eun-Ju (Department of Family Medicine, Pusan National University Yangsan Hospital) ;
  • Kim, Kyung-Mi (Department of Family Medicine, Pusan National University Hospital)
  • 정성인 (부산대학교병원 가정의학과) ;
  • 이승훈 (부산대학교병원 가정의학과) ;
  • 김윤진 (부산대학교병원 가정의학과) ;
  • 이상엽 (부산대학교 의과대학 의학 교육실) ;
  • 이정규 (부산대학교병원 가정의학과) ;
  • 이유현 (부산대학교병원 가정의학과) ;
  • 조영혜 (부산대학교 의과대학 가정의학교실) ;
  • 탁영진 (부산대학교병원 가정의학과) ;
  • 황혜림 (부산대학교병원 가정의학과) ;
  • 박은주 (양산부산대학교병원 가정의학과) ;
  • 김경미 (부산대학교병원 가정의학과)
  • Received : 2018.05.10
  • Accepted : 2018.06.26
  • Published : 2018.09.01
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Abstract

Purpose: To provide effective palliative care, it is important to predict not only patients' life expectancy but their discharge status at a time of inpatient admission to a hospice care facility. This study was aimed to identify meaningful life expectancy indicators that can be used to predict patients' discharge status on admission to the facility. Methods: Among 568 patients who were admitted to the hospice ward of P hospital from April 1, 2016 through December 31, 2017, 377 terminal cancer patients were selected. This retrospective cohort study was performed by using performance status, symptoms and signs, socioeconomic status, laboratory findings on admission. Results: Alive discharge was associated with a good performance status that was measured with the Karnofsky and Eastern Cooperative Oncology Group (ECOG) scales and the Global health and Mental status. Less anorexia, dyspnea, dysphagia and fatigue were also associated with symptoms and signs. Associated laboratory findings were close to normal Complete Blood Cell (CBC) count, Liver Function Test (LFT) and Blood Urea Nitrogen (BUN). Conclusion: Our findings suggest that Karnofsky Performance Status (KPS), ECOG, Global health, Mental status, anorexia, dyspnea, dysphagia, fatigue, CBC, LFT, BUN are meaningful indicators when predicting discharge status for inpatients. Further investigation is warranted.

목적: 호스피스 완화의료에서 환자의 기대 여명 예측뿐 아니라 퇴원형태를 예측하여 적절한 치료를 제공할 필요가 있다. 이번 연구에서는 입원 초기 환자의 퇴원 형태 예측에 유의한 요소들을 알아보고 효율적인 완화의료의 방향에 대해 제시하고자 한다. 방법: 2016년 4월 1일부터 2017년 12월 31일까지 P병원 호스피스 병동에 입원한 말기암환자 568명 중 377명을 대상으로 하였으며 입원 시 사정한 환자의 수행 지수, 증상 및 징후, 사회 경제적 상태와 혈액검사 자료를 바탕으로 연구를 진행하였다. 결과: 입원 당시 높은 수행지수, 양호한 증상 및 징후, 정상에 가까운 혈액검사 수치를 보일 때 생존 퇴원할 가능성이 높았다. 결론: 환자의 퇴원형태 예측에 ECOG, KPS, Global health, Mental status와 같은 수행지수, dyspnea, anorexia, dysphagia, fatigue와 같은 증상 및 징후, CBC, LFT, BUN, CRP 혈액검사 수치가 유의한 지표임을 확인하였다.

Keywords

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