Epidemiological profile and clinical stage of patients in palliative care at a university hospital

ABSTRACT Introduction: Palliative Care aims to promote the quality of life of patients and their families in the face of illnesses that threaten the continuity of life. It is the responsibility of the multidisciplinary team, in the case of incurable and/or terminal illnesses, to offer all available palliative care without undertaking unnecessary diagnostic or therapeutic actions. Therefore, understanding the epidemiological profile of these patients and the correct therapeutic management becomes urgent. Objective: To analyze the epidemiological profile, clinical outcome and the profile of resident doctors responsible for the care of patients in palliative care admitted to the University Hospital of Aracaju/SE. Method: Longitudinal study lasting one year, in which medical records were analyzed and questionnaires were applied to evaluate patients and the resident doctors who were responsible for their care. Result: 40 patients and 17 resident doctors were studied. Significance was observed for the presence of neoplasia with metastasis (p=0.02), use of antiemetics (p=0.0003) and the indication of full palliative care (0.08). Most patients had a Charlson Comorbidity Index > 5, Eastern Cooperative Oncology Group Performance Status ≥ 3, Karnofsky Performance Status < 70% and Palliative Performance Scale ≤ 50%; both showed a certain tendency towards association, which could possibly be resolved with a larger sample “n”. Around 17.64% of resident doctors reported insufficient teaching on palliative care during their undergraduate studies, while 29.41% reported the same insufficiency during medical residency. Despite this, 85.71% of the answers to the surprise question were compatible with reality. The majority of the patients (75%) died during the one-year research. Conclusion: The large percentage of patient deaths and correct answers to the surprise question may signal a late indication for palliative care in HU-Aju, probably due to the mistaken understanding that palliative care is a therapeutic approach necessary only in the terminality and end-of-life process.