Factors associated with the goal of treatment in the last week of life in old compared to very old patients: a population-based death certificate survey

BMC Geriatrics

Research Article

Nele Van Den Noortgate¹  Joachim Cohen²  Rebecca Verhofstede²  Tinne Smets²  Luc Deliens³ 

[1] Department of Geriatrics, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium;Faculty of Medicine and Pharmacy, End-of-life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium;Faculty of Medicine and Pharmacy, End-of-life Care Research Group, Vrije Universiteit Brussel & Ghent University, Laarbeeklaan 103, 1090, Brussels, Belgium;Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands;

关键词: Palliative care;    End-of-life care;    Older people;   

DOI  :  10.1186/1471-2318-14-61

 received in 2013-10-11, accepted in 2014-05-02,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundLittle is known about the type of care older people of different ages receive at the end of life. The goal of treatment is an important parameter of the quality of end-of-life care. This study aims to provide an evaluation of the main goal of treatment in the last week of life of people aged 86 and older compared with those between 75 and 85 and to examine how treatment goals are associated with age.MethodsPopulation- based cross sectional survey in Flanders, Belgium. A stratified random sample of death certificates was drawn of people who died between 1 June and 30 November 2007. The effective study sample included 3,623 deaths (response rate: 58.4%). Non-sudden deaths of patients aged 75 years and older were selected (N = 1681). Main outcome was the main goal of treatment in the last week of life (palliative care or life-prolonging/curative treatment).ResultsIn patients older than 75, the main goal of treatment in the last week was in the majority of cases palliative care (77.9%). Patients between 75 and 85 more often received life-prolonging/curative treatment than older patients (26.6% vs. 15.8%). Most patient and health care characteristics are similarly related to the main goal of treatment in both age groups. The patient’s age was independently related to having comfort care as the main goal of treatment. The main goal of treatment was also independently associated with the patient’s sex, cause and place of death and the time already in treatment.ConclusionAge is independently related to the main goal of treatment in the last week of life with people over 85 being more likely to receive palliative care and less likely to receive curative/life-prolonging treatment compared with those aged 75–85. This difference could be due to the patient’s wishes but could also be the result of the attitudes of care givers towards the treatment of older people.

【 授权许可】

CC BY   
© Smets et al.; licensee BioMed Central Ltd. 2014