Palliative care requirement in neurologic diseases

Abstract

Objective: It has been reported that the need for palliative care (PC) increases every day in chronic critical illnesses such as neurologic disorders. We investigated the demographics and comorbidities of neurological patients followed up in a PC center (PCC), and their effect on hospitalization period and discharge status. Materials and Methods: The medical records of 175 patients followed up in the PCC were reviewed retrospectively. Neurologic disorders were classified as stroke (ischemic and hemorrhagic), neurologic system tumors, brain hypoxia, dementia, Parkinson’s disease, traumatic brain injury (TBI), and other diseases (amyotrophic lateral sclerosis, multiple sclerosis). Age, sex, PCC length of hospital stay (LOS), Glasgow Coma Scale (GCS), nutritional status [oral, percutaneous endoscopic gastrostomy (PEG)], tracheostomy, pressure ulcer, and discharge status were compared for the patients. Results: The diagnoses of the patients whose average age was 66.58±19.97 years and LOS was 35.63±41.93 days were most often stroke and dementia (45.7% and 17%, respectively). In patients with PEG and tracheostomy, LOS in PCC was significantly longer, and patients with tracheostomy had a higher discharge rate. GCS was significantly lower in patients with TBI, whereas the home discharge rate was determined to be higher. Furthermore, age and GCS values of patients whose discharge status was exitus were found to be significantly higher. Conclusion: Even though neurologic diseases represent the most common patient population after cancer in need of PC, there are insufficient studies for describing the characteristics of this population, meeting their needs, and increasing awareness in this area.