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Titolo:
Dialysis discontinuation and palliative care
Autore:
Cohen, LM; Germain, M; Poppel, DM; Woods, A; Kjellstrand, CM;
Indirizzi:
Baystate Med Ctr, Dept Psychiat, Springfield, MA 01199 USA Baystate Med Ctr Springfield MA USA 01199 hiat, Springfield, MA 01199 USA Western New England Renal Associates, Springfield, MA USA Western New England Renal Associates Springfield MA USA ingfield, MA USA Loyola Med Ctr, Dept Med, Chicago, IL USA Loyola Med Ctr Chicago IL USALoyola Med Ctr, Dept Med, Chicago, IL USA Aksys Ltd, Chicago, IL USA Aksys Ltd Chicago IL USAAksys Ltd, Chicago, IL USA
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 1, volume: 36, anno: 2000,
pagine: 140 - 144
SICI:
0272-6386(200007)36:1<140:DDAPC>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
GOOD DEATH; LONG-TERM; WITHDRAWAL; PREFERENCES; DECISIONS;
Keywords:
dialysis discontinuation; palliative care; quality of life;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Cohen, LM Baystate Med Ctr, Dept Psychiat, Springfield, MA 01199 USA Baystate Med Ctr Springfield MA USA 01199 ngfield, MA 01199 USA
Citazione:
L.M. Cohen et al., "Dialysis discontinuation and palliative care", AM J KIDNEY, 36(1), 2000, pp. 140-144

Abstract

Little attention has been accorded to the terminal course and end-of-life care of patients after dialysis discontinuation. This prospective cohort observational study involves six dialysis clinics in the United States and two clinics in Canada. Data were collected on 131 patients who were undergoing maintenance dialysis and died after treatment discontinuation. Seventy-nine of the patients (60%) were prospectively studied until their deaths. Caregivers and families provided information about the symptoms and treatment provided in the final 24 hours of life, and structured interviews were conducted at the time of stopping dialysis with patients and families. The patient population was primarily white (73%), elderly (70 +/- 1.2 years), and diabetic (46%). Three quarters of the subjects had between three and seven comorbid conditions. pain and agitation were the most common symptoms duringthe last day of life. Terminal treatment was generally considered to be satisfactory, and most people had good deaths, Although dialysis prolongs life, the integration of palliative medicine into dialysis programs offers opportunities to improve the quality of end-of-life care, especially for thosepatients who elect to stop treatment. Recommendations include making advance care planning an expectation at all clinics and using quality-of-dying measures to establish benchmarks for the provision of terminal care. (C) 2000 by the National Kidney Foundation, Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 14:54:37