Avaliação dos pacientes idosos em cuidados paliativos no serviço de urgência do Hospital Universitário de Lagarto

Abstract

The increase in the age of the population and the advancement of technologies applied to health without great impact on the quality of life has made it increasingly necessary to implement palliative care in the elderly to improve the quality of care for these patients. This study aims to evaluate the profile of elderly patients in palliative care hospitalized in the emergency room of a university hospital. Cross-sectional study carried out at the University Hospital of Lagarto in the period between February and April 2019 using interviews with the patient or his companion, review of the chart and application of the Charlson scales, Palliative Performance Scale and Karnofsky Scale. The elderly patients admitted to the emergency room and with indication of palliative care confirmed by the NECPAL score were eligible to participate in the study. Thirty patients were evaluated. The majority of patients were indicated for palliative care due to the diagnosis of dementia syndrome. The patients were hospitalized mainly due to infectious syndromes. The mean value of the Charlson comorbidity index 7,667. The functional reserve level in general was low, the average being 16.33% calculated by the PPS. Of the 29 patients with a defined outcome, 55.2% were discharged from hospital and 41.7% died. Statistical and clinical correlation was observed between the low functional reserve level PPS (p = 0.058) or KPS (p = 0.003) and the unfavorable outcome. Dementia syndromes were the main causes of indication of palliative care, no correlation was found between age and outcome at admission, and the functional reserve level correlated with the outcome. More studies are needed to follow patients after discharge.