Journal of Hospice and Palliative Care

Korean Society for Hospice and Palliative Care (한국호스피스완화의료학회)
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Comparison of End-of-Life Care Intensity between Cancer and Non-cancer Patients: a Single Center Experience

암환자와 비-암환자의 임종기 치료 강도 비교: 단일 연구기관 자료

  • Kim, Jae Min (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Baek, Sun Kyung (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Kim, Si-Young (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Maeng, Chi Hoon (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Han, Jae Joon (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Park, Soyoung (Department of Internal Medicine, Kyung Hee University School of Medicine) ;
  • Park, Jae Hun (Department of Internal Medicine, Kyung Hee University School of Medicine)
  • 김재민 (경희대학교병원 내과학교실) ;
  • 백선경 (경희대학교병원 내과학교실) ;
  • 김시영 (경희대학교병원 내과학교실) ;
  • 맹치훈 (경희대학교병원 내과학교실) ;
  • 한재준 (경희대학교병원 내과학교실) ;
  • 박소영 (경희대학교병원 내과학교실) ;
  • 박재훈 (경희대학교병원 내과학교실)
  • Received : 2015.09.25
  • Accepted : 2015.10.22
  • Published : 2015.12.01
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Abstract

Purpose: The aging of society has rapidly progressed, especially in Korea. Therefore, the necessity of research on end-of-life (EOL) care in elderly patients has increased. However, there are few studies on EOL care intensity for non-cancer patients. This study was designed to compare the EOL care intensity between cancer and non-cancer patients. Methods: We retrospectively analyzed the EOL care intensity based on medical records of decedents of Kyung Hee University Medical Center, a tertiary referral hospital from December 2014 through March 2015. And we compared EOL care intensity between cancer patients and non-cancer patients using statistical analysis of the frequency of invasive procedures and logistic regression analysis for factors that affect the EOL care intensity. Results: Statistical analysis showed invasive procedures, such as intensive care unit admission, endotracheal intubation followed by mechanical ventilation and emergency dialysis, were performed more frequently in non-cancer patients than cancer patients (29.3% vs. 72.4%, P<0.001). And age (P=0.038) and morbidity of cancer (P<0.001) influenced the invasive procedural decision when analyzed by logistic regression analysis. Conclusion: The EOL care was more intensive in non-cancer patients, and age and morbidity of cancer were major factors for the treatment intensity.

목적: 의학의 발달로 인구가 고령화됨에 따라, 사망의 원인이 되는 질환 및 동반질환의 유병기간은 함께 증가하고 있으며, 고령환자의 임종기 관리에 대한 연구의 필요성도 더욱 증가하고 있다. 그러나 임종기 치료 강도에 대한 국내연구는 암환자에 국한되어 있으며, 비-암환자의 임종기 치료 강도에 대한 국내 연구는 없었다. 그래서 본 연구는 암환자와 비-암환자의 임종기 치료 강도에 대해 연구하였다. 방법: 경희대학교병원에서 2014년 12월 1일부터 2015년 3월 31일까지 4개월간 사망자의 의무기록을 조사하여 암환자와 비-암환자의 기본 인구학적 정보, 임종기 치료 강도, 심폐소생술 금지 요청서 경향 등에 대해 비교 연구하였다. 결과: 비-암환자가 암환자에 비해 나이가 많았음에도 불구하고(73.7 vs. 67.4, P=0.001), 중환자실 치료(87.4% vs. 36.0%, P<0.001), 기도 삽관 및 기계 호흡(63.2% vs. 24%, P<0.001), 응급 투석(28.7% vs. 8.0%, P=0.001)을 더 많이 받은 것으로 나타났으며, 나이(P=0.038), 암의 유병 여부(P<0.001)가 임종기 침습적 치료에 영향을 미치는 인자로 나타났다. 결론: 임종기 치료 강도는 비-암환자에서 더 높은 것으로 나타났으며, 나이와 암의 유병여부가 임종기 치료 강도를 결정하는 중요한 인자였다.

Keywords

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