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Patient’s Factors at Entering Hospice Affecting Length of Survival in a Hospice Center
이국진,안혜신,고세은,김지현,서민우,강승헌,양여리,이미영,이구옥,전상훈,진종률 대한암학회 2015 Cancer Research and Treatment Vol.47 No.1
Purpose In order to provide effective hospice care, adequate length of survival (LOS) in hospice isnecessary. However the reported average LOS is much shorter. Analysis of LOS in hospicehas not been reported from Korea. We evaluated the duration of LOS and the factorsassociated with LOS at our hospice center. Materials and MethodsWe retrospectively examined 446 patients who were admitted to our hospice unit betweenJanuary 2010 and December 2012. We performed univariate and multivariate analysis foranalysis of factors associated with LOS. ResultsThe median LOS was 9.5 days (range, 1 to 186 days). The LOS of 389 patients (86.8%)was< 1 month. At the time of admission to hospice, 112 patients (25.2%) were completelybedridden, 110 patients (24.8%) had mouth care only without intake, and 134 patients(30.1%) had decreased consciousness, from confusion to coma. The median time intervalbetween the day of the last anticancer treatment and the day of hospice admission was 75days. By analysis of the results of multivariate analysis, decreased intake and laboratoryresults showing increased total white blood cell (WBC), decreased platelet count, increasedserum creatinine, increased aspartate aminotransferase (AST), alanine aminotransferase(ALT), and lactate dehydrogenase (LDH) level were poor prognostic factors for survival inhospice. ConclusionBefore hospice admission, careful evaluation of the patient’s performance, particularly theoral intake, and total WBC, platelet, creatinine, AST, ALT, and LDH level is essential, becausethese were strong predictors of shorter LOS. In the future, conduct of prospective controlledstudies is warranted in order to confirm the relationship between potential prognostic factorsand LOS in hospice.
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