Incidence of advanced chronic disease, need for palliative care and in-hospital mortality

Authors

  • José Luis Canizal-Oñate <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Medicina Interna. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0009-0007-9967-0870
  • Drusila Tovar-Rodríguez <p>Universidad Veracruzana, Campus Veracruz, Facultad de Medicina.&nbsp;Veracruz, Veracruz, M&eacute;xico .</p> http://orcid.org/0000-0001-9471-6082
  • Norma León-Armas <p>Universidad Aut&oacute;noma de Tlaxcala, Facultad de Medicina.&nbsp;Tlaxcala, Tlaxcala, M&eacute;xico.</p> http://orcid.org/0000-0002-9575-4854
  • Gabriela Martínez-Díaz <p>Benem&eacute;rita Universidad Aut&oacute;noma de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, M&eacute;xico.&nbsp;</p> http://orcid.org/0009-0001-3274-8107
  • Berenice López-Zamora <p>Instituto Polit&eacute;cnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tom&aacute;s, Secci&oacute;n de Estudios de Posgrado e Investigaci&oacute;n. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0003-1917-1240
  • María del Pilar Cruz-Domínguez <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Direcci&oacute;n de Educaci&oacute;n e Investigaci&oacute;n en Salud. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0002-7118-9395
  • Michelle Arrucha-Cozaya <p>Benem&eacute;rita Universidad Aut&oacute;noma de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0009-0006-1980-4537
  • Olga Lidia Vera-Lastra <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Departamento de Medicina Interna, Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0002-8729-9775
  • Gabriela Medina-García <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Investigaci&oacute;n en Medicina Traslacional en Enfermedades Hemato-oncol&oacute;gicas. Ciudad de M&eacute;xico, M&eacute;xico.</p> http://orcid.org/0000-0002-5891-8653

DOI:

https://doi.org/10.5281/zenodo.10711920

Keywords:

Mortality, Prognosis, Chronic Disease, Palliative Care

Abstract

Background: There is a continuing increase in the prevalence of people affected with progressive chronic diseases. Palliative care is another form of care and organization of health problems that improve quality.

Objective: To determine the incidence of patients with advanced chronic illness and need of palliative care (NPC) and intrahospital mortality in a reference hospital.

Methods:  Prospective observational study in hospitalized patients over 18 years of age in the internal medicine department who met at least one criterion of the NECPAL CCOMS-ICO tool. They were followed until death or discharge to determine intrahospital mortality. We used descriptive and inferential statistics.

Results: We studied 370 admissions from April to August 2021, including 110 patients, 59 women (55.3%) and 51 men (44.7%), age 65.5 ± 15.85 years. The incidence of NPC was 29.7%. The most frequent comorbidity was oncologic in 39 patients (35.5%), followed by chronic heart disease in 17 patients (15.5%); 38 patients were classified as NECPAL grade I (34.5%), 44 NECPAL II (40%) and 28 NECPAL III (25.5%). Twenty-five patients died during their in-hospital stay, with a mortality of 22.7%.

Conclusions: The incidence of hospitalized patients in need of palliative care is considerable, more than half of them for non-oncologic pathology. More effective care strategies are required for external referral and multidisciplinary in-hospital care.

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Author Biographies

  • José Luis Canizal-Oñate, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Servicio de Medicina Interna. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Servicio de Medicina Interna. 

  • Drusila Tovar-Rodríguez, <p>Universidad Veracruzana, Campus Veracruz, Facultad de Medicina.&nbsp;Veracruz, Veracruz, M&eacute;xico .</p>

    Universidad Veracruzana, Campus Veracruz, Facultad de Medicina.

  • Norma León-Armas, <p>Universidad Aut&oacute;noma de Tlaxcala, Facultad de Medicina.&nbsp;Tlaxcala, Tlaxcala, M&eacute;xico.</p>

    Universidad Autónoma de Tlaxcala, Facultad de Medicina.

  • Gabriela Martínez-Díaz, <p>Benem&eacute;rita Universidad Aut&oacute;noma de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, M&eacute;xico.&nbsp;</p>

    Benemérita Universidad Autónoma de Puebla, Campus Puebla, Facultad de Medicina. 

  • Berenice López-Zamora, <p>Instituto Polit&eacute;cnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tom&aacute;s, Secci&oacute;n de Estudios de Posgrado e Investigaci&oacute;n. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Instituto Politécnico Nacional, Escuela Superior de Medicina, Campus Casco de Santo Tomás, Sección de Estudios de Posgrado e Investigación. 

  • María del Pilar Cruz-Domínguez, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Direcci&oacute;n de Educaci&oacute;n e Investigaci&oacute;n en Salud. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Dirección de Educación e Investigación en Salud.  

  • Michelle Arrucha-Cozaya, <p>Benem&eacute;rita Universidad Aut&oacute;noma de Puebla, Campus Puebla, Facultad de Medicina. Puebla, Puebla, M&eacute;xico.</p>

    Benemérita Universidad Autónoma de Puebla, Campus Puebla, Facultad de Medicina. 

  • Olga Lidia Vera-Lastra, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Departamento de Medicina Interna, Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades “Dr. Antonio Fraga Mouret”, Departamento de Medicina Interna, Ciudad de México, México 

  • Gabriela Medina-García, <p>Instituto Mexicano del Seguro Social, Centro M&eacute;dico Nacional La Raza, Hospital de Especialidades &ldquo;Dr. Antonio Fraga Mouret&rdquo;, Unidad de Investigaci&oacute;n en Medicina Traslacional en Enfermedades Hemato-oncol&oacute;gicas. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    Investigador Asociado D.Miembro del sistema Nacional de Investigadores nivel 2

    Unidad de Investigación en medicina traslacional en enfermedades hematooncológicas

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Published

2024-03-27

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