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Characteristics of advanced cancer patients who were readmitted to an acute palliative/supportive care unit

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Abstract

Objectives

The aim of this study was to assess the characteristics of patients readmitted to an acute supportive/palliative care unit (ASPCU), the reasons for readmission, and the outcome after receiving specialistic assessment and treatment.

Methods

A consecutive sample of patients was assessed for a period of 10 months. Epidemiological characteristics, including age, gender, Karnofsky level, diagnosis, caregivers, education, disease awareness, kind of admission, and anticancer treatment in the previous 30 days, were recorded, as well as hospital stay, death, and discharge at home. The principal reasons for admission were recorded. Symptom intensity and opioid doses, expressed as oral morphine equivalents, were also measured.

Results

In the study period, 79 (25.2%) readmissions were recorded. Thirty-seven (46.8%) readmissions occurred within 30 days after discharge. Pain was more frequently reported as indication for admission at the first and the second readmission in comparison with the first admission. The burden of symptoms was significantly higher in patients with a readmission in comparison with patients at the first admission. Opioid doses, expressed as oral morphine equivalents, were significantly different between the first admission and readmissions. In both patients at the first admission or readmission, a significant decrease in symptom intensity has been reported at discharge.

Conclusion

About 25% of patients discharged from an ASCPU are expected to be readmitted for reemerging of clinical problems. Re-exacerbation of pain seems to be the most frequent reason. A further clinical reassessment and treatment were equally effective in controlling the symptom burden of these patients at any readmission.

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Authors and Affiliations

  1. Anesthesia and Intensive Care Unit and Supportive-Palliative Care Unit, La Maddalena Cancer Center, Via san Lorenzo 312, 90145, Palermo, Italy

    Sebastiano Mercadante, Claudio Adile & Patrizia Ferrera

  2. Department of Sciences for Health Promotion and Mother Child Care, University of Palermo, Palermo, Italy

    Alessandra Casuccio

Authors
  1. Sebastiano Mercadante
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  2. Claudio Adile
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  3. Patrizia Ferrera
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  4. Alessandra Casuccio
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Corresponding author

Correspondence to Sebastiano Mercadante.

Ethics declarations

The institutional review board at the University of Palermo approved the study, and written patients’ informed consent was obtained.

Conflict of interest

The authors declare that they have no conflict of interest.

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Mercadante, S., Adile, C., Ferrera, P. et al. Characteristics of advanced cancer patients who were readmitted to an acute palliative/supportive care unit. Support Care Cancer 25, 1947–1952 (2017). https://doi.org/10.1007/s00520-017-3604-0

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  • DOI: https://doi.org/10.1007/s00520-017-3604-0

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