Patterns of care in advanced HIV disease in a tertiary treatment centre.
International conference on biopsychoso cial aspects of HIV & AIDS. Brighton GBR, 1994/07/07.
A retrospective chart review of all in-patient deaths in 1992 was undertaken to examine patterns of care in advanced HIV disease at St Paul's Hospital, Vancouver, Canada.
St Paul's Hospital cares for approximately 75% of the Province of British Columbia's AIDS caseload.
This represents about 18% of Canada's caseload.
Data were collected on demographic characteristics, the utilization of home care and community services, income and social support, symptom presentation at terminal admission and the utilization of acute hospital care and hospital based palliative care.
A total of 126 deaths were reviewed.
All but two subjects were homosexual/bisexual men.
The median age at death was 39 years (range 24-67).
Four patterns of care at death were identified :
(1) aggressive therapy with resuscitation 24 (19%), (resuscitation was initiated in 58%) ;
(2) aggressive pathology with a no resuscitation order 49 (39%), in which the palliative period was a median of three days ;
(3) death on the palliative care unit following respite admissions 16 (13%), with a median survival once palliative of 64 days.
Despite a well known and respected Palliative Care Unit and community palliative care programme, there is a marked trend towards death occuring during aggressive therapy with a 200% increase in the initiation of resuscitation compared to the previous three years.
Mots-clés Pascal : Choix, Traitement palliatif, Réanimation, Soin, Canada, Amérique du Nord, Amérique, Homme, SIDA, Virose, Infection, Stade terminal, Immunopathologie, Immunodéficit, Démographie, Utilisation, Service santé, Hospitalisation, Traitement communautaire, Symptomatologie, Statut social, Typologie, Mortalité
Mots-clés Pascal anglais : Choice, Palliative treatment, Resuscitation, Care, Canada, North America, America, Human, AIDS, Viral disease, Infection, Terminal stade, Immunopathology, Immune deficiency, Demography, Use, Health service, Hospitalization, Community treatment, Symptomatology, Social status, Typology, Mortality
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0220435
Code Inist : 002B06D01. Création : 09/06/1995.