Changes in the Use of Intensive and Supportive Procedures for Patients With Stroke in Taiwan in the Last Month of Life Between 2000 and 2010

Pei Yi Wang, Yen Ni Hung, Robert Smith, Chia-Chin Lin

研究成果: 雜誌貢獻文章

1 引文 (Scopus)

摘要

Context: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life and what trends in care are in recent years. Objectives: The objective of this study was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Methods: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Results: Over the whole study period, 25.4% of patients with stroke were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (77.4%–67.9%), cardiopulmonary resuscitation (53.8%–35.8%), and inotropic agents (73.5%–64.3%) decreased over time. The percentages of patients receiving artificial hydration and nutrition (65.9%–73.3%) and sedative or analgesic agents (34.7%–38.6%) increased over time. Patients under 85 years old were more likely to be admitted to intensive care units. Men were more likely to receive mechanical ventilation and cardiopulmonary resuscitation than women. Conclusion: Over time, the use of supportive procedures increased, and the use of intensive procedures decreased in patients with stroke in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with stroke.

原文英語
頁(從 - 到)835-842
頁數8
期刊Journal of Pain and Symptom Management
55
發行號3
DOIs
出版狀態已發佈 - 三月 1 2018

指紋

Taiwan
Stroke
Cardiopulmonary Resuscitation
Artificial Respiration
Intensive Care Units
Insurance Claim Review
National Health Programs
Hypnotics and Sedatives
Palliative Care
Research
Analgesics
Cause of Death
Patient Care
Databases
Guidelines

ASJC Scopus subject areas

  • Nursing(all)
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

引用此文

Changes in the Use of Intensive and Supportive Procedures for Patients With Stroke in Taiwan in the Last Month of Life Between 2000 and 2010. / Wang, Pei Yi; Hung, Yen Ni; Smith, Robert; Lin, Chia-Chin.

於: Journal of Pain and Symptom Management, 卷 55, 編號 3, 01.03.2018, p. 835-842.

研究成果: 雜誌貢獻文章

@article{420f0e7f49744fa480ac73041875b053,
title = "Changes in the Use of Intensive and Supportive Procedures for Patients With Stroke in Taiwan in the Last Month of Life Between 2000 and 2010",
abstract = "Context: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life and what trends in care are in recent years. Objectives: The objective of this study was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Methods: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Results: Over the whole study period, 25.4{\%} of patients with stroke were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (77.4{\%}–67.9{\%}), cardiopulmonary resuscitation (53.8{\%}–35.8{\%}), and inotropic agents (73.5{\%}–64.3{\%}) decreased over time. The percentages of patients receiving artificial hydration and nutrition (65.9{\%}–73.3{\%}) and sedative or analgesic agents (34.7{\%}–38.6{\%}) increased over time. Patients under 85 years old were more likely to be admitted to intensive care units. Men were more likely to receive mechanical ventilation and cardiopulmonary resuscitation than women. Conclusion: Over time, the use of supportive procedures increased, and the use of intensive procedures decreased in patients with stroke in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with stroke.",
keywords = "cerebrovascular stroke, End-of-life care, life support care, stroke, terminal care, terminally ill",
author = "Wang, {Pei Yi} and Hung, {Yen Ni} and Robert Smith and Chia-Chin Lin",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.jpainsymman.2017.11.024",
language = "English",
volume = "55",
pages = "835--842",
journal = "Journal of Pain and Symptom Management",
issn = "0885-3924",
publisher = "Elsevier Inc.",
number = "3",

}

TY - JOUR

T1 - Changes in the Use of Intensive and Supportive Procedures for Patients With Stroke in Taiwan in the Last Month of Life Between 2000 and 2010

AU - Wang, Pei Yi

AU - Hung, Yen Ni

AU - Smith, Robert

AU - Lin, Chia-Chin

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Context: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life and what trends in care are in recent years. Objectives: The objective of this study was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Methods: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Results: Over the whole study period, 25.4% of patients with stroke were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (77.4%–67.9%), cardiopulmonary resuscitation (53.8%–35.8%), and inotropic agents (73.5%–64.3%) decreased over time. The percentages of patients receiving artificial hydration and nutrition (65.9%–73.3%) and sedative or analgesic agents (34.7%–38.6%) increased over time. Patients under 85 years old were more likely to be admitted to intensive care units. Men were more likely to receive mechanical ventilation and cardiopulmonary resuscitation than women. Conclusion: Over time, the use of supportive procedures increased, and the use of intensive procedures decreased in patients with stroke in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with stroke.

AB - Context: Stroke is the second leading cause of death and the primary cause of disability worldwide. It is uncertain what care patients with stroke receive in their end of life and what trends in care are in recent years. Objectives: The objective of this study was to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Methods: Analysis of claims data of 55,930 patients with stroke obtained from the National Health Insurance Research Database was performed to investigate the changes in the use of intensive and supportive procedures for Taiwanese patients with stroke in their last month of life during 2000–2010. Results: Over the whole study period, 25.4% of patients with stroke were admitted to intensive care units in their last month of life. The percentages of patients receiving mechanical ventilation (77.4%–67.9%), cardiopulmonary resuscitation (53.8%–35.8%), and inotropic agents (73.5%–64.3%) decreased over time. The percentages of patients receiving artificial hydration and nutrition (65.9%–73.3%) and sedative or analgesic agents (34.7%–38.6%) increased over time. Patients under 85 years old were more likely to be admitted to intensive care units. Men were more likely to receive mechanical ventilation and cardiopulmonary resuscitation than women. Conclusion: Over time, the use of supportive procedures increased, and the use of intensive procedures decreased in patients with stroke in the last month of life. This study highlights a need for research, guidelines, and training in how to provide palliative care for end-stage patients with stroke.

KW - cerebrovascular stroke

KW - End-of-life care

KW - life support care

KW - stroke

KW - terminal care

KW - terminally ill

UR - http://www.scopus.com/inward/record.url?scp=85041623988&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85041623988&partnerID=8YFLogxK

U2 - 10.1016/j.jpainsymman.2017.11.024

DO - 10.1016/j.jpainsymman.2017.11.024

M3 - Article

AN - SCOPUS:85041623988

VL - 55

SP - 835

EP - 842

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 3

ER -