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      Impact of COVID-19 on the End-of-Life Care of Cancer Patients Who Died in a Korean Tertiary Hospital: A Retrospective Study

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      https://www.riss.kr/link?id=A108372017

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      다국어 초록 (Multilingual Abstract)

      Purpose: Social distancing and strict visitor restrictions at hospitals have been national policies since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This has challenged the concept of a good death in comfort with the opportunity to...

      Purpose: Social distancing and strict visitor restrictions at hospitals have been national policies since the onset of the coronavirus disease 2019 (COVID-19) pandemic. This has challenged the concept of a good death in comfort with the opportunity to say goodbye.
      Little is known about how these measures have influenced end-of-life (EOL) care among cancer patients who die in acute care hospitals. This study examined changes in the EOL care of cancer patients during the COVID-19 pandemic. Methods: We retrospectively analyzed 1,456 adult cancer patients who died in 2019 (n=752) and 2020 (n=704) at a tertiary hospital. Data on EOL care—symptom control and comfort care in an imminently dying state, preparation for death, place of death, and aggressive care in the last month— were reviewed. Results: The 1,456 patients had a median age of 67 years, and 62.5% were men. Patients who died in 2020 were more likely to experience agitation or delirium before death (17.2% vs. 10.9%), to use inotropes/vasopressors near death (59.2% vs. 52.3%), and to receive cardiopulmonary resuscitation in their last months (16.3% vs. 12.5%) than those who died in 2019. Additionally, the number of deaths in the emergency room doubled in 2020 compared to 2019 (from 7.1% to 14.1%). Conclusion: This study suggests that EOL care for cancer patients who died in a tertiary hospital deteriorated during the COVID-19 pandemic. The implementation of medical care at the EOL and the preferred place of death should be discussed carefully in advance for high-quality EOL care.

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      참고문헌 (Reference) 논문관계도

      1 Etkind SN, "The role and response of palliative care and hospice services in epidemics and pandemics : a rapid review to inform practice during the COVID-19 pandemic" 60 : e31-e40, 2020

      2 Inouye SK, "The importance of Delirium and Delirium prevention in older adults during lockdowns" 325 : 1779-1780, 2021

      3 Manca R, "The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia : a review" 11 : 585540-, 2020

      4 Cheng HW, "The first confirmed case of human avian influenza A(H7N9)in Hong Kong and the suspension of volunteer services : impact on palliative care" 47 : e5-e7, 2014

      5 이하연 ; 김화정 ; 권정혜 ; 백선경 ; 원영웅 ; 김유정 ; 백수진 ; 류혜원, "The Situation of Life-Sustaining Treatment One Year After Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment" 대한암학회 53 (53): 897-907, 2021

      6 Guo D, "Risk factors for delirium in the palliative care population : a systematic review and meta-analysis" 12 : 772387-, 2021

      7 Singer PA, "Quality end-of-life care : patients’ perspectives" 281 : 163-168, 1999

      8 Malagon T, "Predicted long-term impact of COVID-19 pandemic-related care delays on cancer mortality in Canada" 150 : 1244-1254, 2022

      9 김예진 ; 유신혜 ; Jeong Mi Shin ; Hyoung Suk Han ; Jinui Hong ; Hyun Jee Kim ; Wonho Choi ; Min Sun Kim ; Hye Yoon Park ; Bhumsuk Keam, "Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19" 한국호스피스완화의료학회 24 (24): 130-134, 2021

      10 Arya A, "Pandemic palliative care : beyond ventilators and saving lives" 192 : E400-E404, 2020

      1 Etkind SN, "The role and response of palliative care and hospice services in epidemics and pandemics : a rapid review to inform practice during the COVID-19 pandemic" 60 : e31-e40, 2020

      2 Inouye SK, "The importance of Delirium and Delirium prevention in older adults during lockdowns" 325 : 1779-1780, 2021

      3 Manca R, "The impact of COVID-19 infection and enforced prolonged social isolation on neuropsychiatric symptoms in older adults with and without dementia : a review" 11 : 585540-, 2020

      4 Cheng HW, "The first confirmed case of human avian influenza A(H7N9)in Hong Kong and the suspension of volunteer services : impact on palliative care" 47 : e5-e7, 2014

      5 이하연 ; 김화정 ; 권정혜 ; 백선경 ; 원영웅 ; 김유정 ; 백수진 ; 류혜원, "The Situation of Life-Sustaining Treatment One Year After Enforcement of the Act on Decisions on Life-Sustaining Treatment for Patients at the End-of-Life in Korea: Data of National Agency for Management of Life-Sustaining Treatment" 대한암학회 53 (53): 897-907, 2021

      6 Guo D, "Risk factors for delirium in the palliative care population : a systematic review and meta-analysis" 12 : 772387-, 2021

      7 Singer PA, "Quality end-of-life care : patients’ perspectives" 281 : 163-168, 1999

      8 Malagon T, "Predicted long-term impact of COVID-19 pandemic-related care delays on cancer mortality in Canada" 150 : 1244-1254, 2022

      9 김예진 ; 유신혜 ; Jeong Mi Shin ; Hyoung Suk Han ; Jinui Hong ; Hyun Jee Kim ; Wonho Choi ; Min Sun Kim ; Hye Yoon Park ; Bhumsuk Keam, "Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19" 한국호스피스완화의료학회 24 (24): 130-134, 2021

      10 Arya A, "Pandemic palliative care : beyond ventilators and saving lives" 192 : E400-E404, 2020

      11 Jung Eujene ; Ro Young Sun ; Ryu Hyun Ho ; Shin Sang Do ; Moon Sungwoo, "Interaction Effects between COVID-19 Outbreak and Community Income Levels on Excess Mortality among Patients Visiting Emergency Departments" 대한의학회 36 (36): 1-11, 2021

      12 Everitt R, "Increased number of deaths within 24 h of admission during a period of social restriction related to the COVID-19 pandemic: A retrospective service evaluation in a metropolitan palliative care unit" 35 : 1508-1513, 2021

      13 Chou YC, "Impact of the COVID-19 pandemic on the utilization of hospice care services : a cohort study in Taiwan" 60 : e1-e6, 2020

      14 National Hospice Center, "Hospice & palliative care in Korea: facts & figures 2020" National Hospice Center & Ministry of Health and Welfare 2022

      15 Persaud TV, "Fetal outcome following maternal treatment with prostaglandin E2" 24 : 75-78, 1986

      16 Steinhauser KE, "Factors considered important at the end of life by patients, family, physicians, and other care providers" 284 : 2476-2482, 2000

      17 Harrison NE, "Factors associated with voluntary refusal of emergency medical system transport for emergency care in Detroit during the early phase of the COVID-19 pandemic" 4 : e2120728-, 2021

      18 COVID-19 Excess Mortality Collaborators, "Estimating excess mortality due to the COVID-19 pandemic : a systematic analysis of COVID-19-related mortality, 2020-21" 399 : 1513-1536, 2022

      19 Ersek M, "End-of-life care in the time of COVID-19 : communication matters more than ever" 62 : 213-222. e2, 2021

      20 Kelly M, "End-of-life care in natural disasters including epidemics and pandemics : a systematic review" 2021

      21 Mott FE, "End-of-life and goals of care discussions with cancer patients in the coronavirus pandemic" 19 : 384-385, 2021

      22 Pak Yun-Suk ; Ro Young Sun ; Kim Se-Hyung ; Han So-Hyun ; Ko Sung-keun ; Kim Taehui ; Kwak Young Ho ; Heo Tag ; Moon Sungwoo, "Effects of Emergency Care-related Health Policies during the COVID-19 Pandemic in Korea: a Quasi-Experimental Study" 대한의학회 36 (36): 1-12, 2021

      23 Maldonado JR, "Delirium in the acute care setting : characteristics, diagnosis and treatment" 24 : 657-722, 2008

      24 Jackel M, "Delirium in critically Ill patients with and without COVID-19-a retrospective analysis" 10 : 4412-, 2021

      25 Helms J, "Delirium and encephalopathy in severe COVID-19 : a cohort analysis of ICU patients" 24 : 491-, 2020

      26 Bone AE, "Changing patterns of mortality during the COVID-19 pandemic : population-based modelling to understand palliative care implications" 34 : 1193-1201, 2020

      27 Hauk H, "Breaking bad news to cancer patients in times of COVID-19" 29 : 4195-4198, 2021

      28 김선주 ; 김현 ; 박유현 ; 강 찬 영 ; 노영선 ; 김오현, "Analysis of the Impact of the Coronavirus Disease Epidemic on the Emergency Medical System in South Korea Using the Korean Triage and Acuity Scale" 연세대학교의과대학 62 (62): 631-639, 2021

      29 National Law Information Center, "Act on decisions on life-sustaining treatment for patients in hospice and palliative care or the end-of-life" Korea Ministry of Government Legislation

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