Symptom- and function-based trajectories of patients with dementia in hospital and community palliative care settings in the last two weeks of life: a retrospective cohort study

作者：Minghui Tan, Xiwen Qin, Claire E. Johnson, Lin Xiao, Angus Cook, Jinfeng Ding, Juan Wang · 发表于：BMC Palliative Care · 年份：2024 · DOI：10.1186/s12904-024-01565-6 · 被引用次数：6 · 研究领域：Palliative Care and End-of-Life Issues、Pain Management and Opioid Use、Dementia and Cognitive Impairment Research

BACKGROUND: The prevalence of dementia is increasing worldwide and many people with the condition require some level of palliative care. However, the trajectories of function and symptom burden in palliative care services at the end of life remain unclear. This study aimed to describe and compare the longitudinal trajectories of function and symptom burden among patients with dementia between hospital versus palliative community care services in the last two weeks of life. METHODS: A retrospective cohort study used data from the Australian Palliative Care Outcomes Collaboration. Patients with dementia who died between 1 January 2013 and 31 December 2020 from the Australian Palliative Care Outcomes Collaboration. Four validated clinical instruments were used to collect outcomes on each individual's function and symptom distress and severity. Multilevel models were used to estimate the differences in clinical trajectories between hospital and community-based palliative care in the last two weeks of life. RESULTS: Patients with dementia tended to have low levels of distress for most symptoms but increasing levels of functional impairment. There were no or only marginally significant differences in the symptom trajectories between the community and hospital groups (OR ranged from 0.57 to 1.97). Although clinical trajectories of function were relatively similar between two groups, statistically higher functional indicators were observed for people when admitted to community pallia...