Factors associated with emergency room visit or hospitalization in care oncology home care: an integrative  review            /Fatores associados à visita à emergência ou hospitalização em cuidados paliativos oncológicos domiciliares: uma revisão integrativa

Flavia Navi de Souza; Vanessa Gomes da Silva; Alexandre Sousa da Silva

doi:10.9789/2175-5361.rpcfo.v15.12000

Autores

Flavia Navi de Souza Federal University of the State of Rio de Janeiro https://orcid.org/0000-0003-1478-7038
Vanessa Gomes da Silva Instituto Nacional do Câncer https://orcid.org/0000-0003-3438-3401
Alexandre Sousa da Silva Federal University of the State of Rio de Janeiro https://orcid.org/0000-0002-5573-4111

DOI:

https://doi.org/10.9789/2175-5361.rpcfo.v15.12000

Palavras-chave:

Cuidados paliativos, Neoplasias, Serviços de assistência domiciliar, Emergência, Hospitalização

Resumo

Objetivo: identificar os fatores associados à visita à emergência ou hospitalização dos pacientes oncológicos em cuidados paliativos domiciliares. Método: revisão integrativa nas bases PubMed, LILACS, Web of Science e Embase. Perguntou-se “quais os fatores associados à visita a serviços de emergência ou hospitalização de pacientes oncológicos em cuidados paliativos domiciliares?”. Descritores foram neoplasias; cuidados paliativos; hospitalização; serviços médicos de emergência; serviços de assistência domiciliar. Critérios de elegibilidade foram texto na íntegra; entre 2012 e 2022; idioma inglês, português ou espanhol; idade adulta. Resultados: foram selecionados 16 artigos. As causas mais comuns de visita à emergência/hospitalização foram dor, falta de ar, infecção, sintomas digestivos, delirium e queda do estado geral/fadiga. Conclusão: este estudo identificou lacunas em que os cuidados paliativos domiciliares podem ser aprimorados.

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Biografia do Autor

Flavia Navi de Souza, Federal University of the State of Rio de Janeiro

Mestranda do Programa de Pós-Graduação em Saúde e Tecnologia no Espaço Hospitalar (PPGSTEH) da Universidade Federal do Estado do Rio de Janeiro - UNIRIO. Médica da unidade de Cuidados Paliativos do Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA), Rio de Janeiro – RJ- Brasil.

Vanessa Gomes da Silva, Instituto Nacional do Câncer

Doutoranda do Programa em Ensino em Biociências e Saúde- IOC/ Fiocruz

Enfermeira e Coordenadora do Serviço de Assistência Domiciliar da Unidade de Cuidados Paliativos do Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA). Rio de Janeiro – RJ - Brasil.

Alexandre Sousa da Silva, Federal University of the State of Rio de Janeiro

Doutor em Estatística. Professor Associado da Universidade Federal do Estado do Rio de Janeiro. Professor do Programa de Pós-Graduação em Saúde e Tecnologia no Espaço Hospitalar (PPGSTEH) da Universidade Federal do Estado do Rio de Janeiro – UNIRIO. Rio de Janeiro – RJ - Brasil.

Referências

World Health Organization (WHO). WHO Cancer Resolution; Cancer prevention and control in the context of an integrated approach. 17th World Heal Assem. [Internet]. 2017 [cited 2022 sep 5]. Available from: https://apps.who.int/iris/handle/10665/275676.

Worldwide Hospice Palliative Care Alliance (WHPCA) [homepage in internet]. Global Atlas of Palliative Care. 2nd Edition. 2020 [cited 2022 sep 5]. Available from: https://www.thewhpca.org/resources/global-atlas-on-end-of-life-care.

Atty AT de M, Tomazelli JG. Cuidados paliativos na atenção domiciliar para pacientes oncológicos no Brasil. Saúde debate. [Internet]. 2018 [acesso em 05 de setembro 2022];42(116). Disponível em: https://doi.org/10.1590/0103-1104201811618.

Bittencourt NCC de M, Santos KA, Mesquita MG da R, Silva VG da, Telles AC, Silva MM da. Sinais e sintomas manifestados por pacientes em cuidados paliativos oncológicos na assistência domiciliar: uma revisão integrativa. Esc. Anna Nery Rev. Enferm. [Internet]. 2021 [acesso em 05 de setembro 2022];25(4). Disponível em: https://doi.org/10.1590/2177-9465-EAN-2020-0520.

OhioHealth Hospice. Vamos falar de Cuidados Paliativos. Soc Bras Geriatr e Gerontol. [Internet]. 2014 [acesso em 05 de setembro 2022];17. Disponível em: https://sbgg.org.br/wp-content/uploads/2014/11/vamos-falar-de-cuidados-paliativos-vers--o-online.pdf.

Mercadante S, Masedu F, Valenti M, Mercadante A, Aielli F. The characteristics of advanced cancer patients followed at home but admitted to the hospital for the last days of life. Intern. emerg. med. [Internet]. 2016 [cited 2022 sep 5];11(5). Available from: https://doi.org/10.1007/s11739-016-1402-1.

Moncho MEI, Palomar-Abril V, Soria-Comes T. Palliative Care Unit at Home: Impact on Quality of Life in Cancer Patients at the End of Life in a Rural Environment. Am J Hosp Palliat Med. [Internet]. 2022 [cited 2022 sep 5];39(5). Available from: https://doi.org/10.1177/10499091211038303.

Dhiliwal SR, Muckaden M. Impact of specialist home-based palliative care services in a tertiary oncology set up: A prospective non-randomized observational study. Indian J Palliat Care. [Internet]. 2015 [cited 2022 sep 5];21(1). Available from: https://doi.org/10.4103/0973-1075.150170.

Riolfi M, Buja A, Zanardo C, Marangon CF, Manno P, Baldo V. Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative homecare team: A retrospective cohort study. Palliat. med. [Internet]. 2014 [cited 2022 sep 5];28(5). Available from: https://doi.org/10.1177/0269216313517283.

Enguidanos S, Rahman A, Fields T, Mack W, Brumley R, Rabow M, et al. Expanding access to home-based palliative care: A randomized controlled trial protocol. J. palliat. med. [Internet]. 2019 [cited 2022 sep 5];22(S1). Available from: https://doi.org/10.1089/jpm.2019.0147.

Sutradhar R, Barbera L, Seow HY. Palliative homecare is associated with reduced high- and low-acuity emergency department visits at the end of life: A population-based cohort study of cancer decedents. Palliat. med. [Internet]. 2017 [cited 2022 sep 5];31(5). Available from: https://doi.org/10.1177/0269216316663508.

Alonso-Babarro A, Astray-Mochales J, Domínguez-Berjón F, Gènova-Maleras R, Bruera E, Díaz-Mayordomo A, et al. The association between in-patient death, utilization of hospital resources and availability of palliative home care for cancer patients. Palliat. med. [Internet]. 2013 [cited 2022 sep 5];27(1). Available from: https://doi.org/10.1177/0269216312442973.

Mracek J, Earp M, Sinnarajah A. Palliative home care and emergency department visits in the last 30 and 90 days of life: A retrospective cohort study of patients with cancer. BMJ support. palliat. care (Online). 2021 [cited 2022 sep 5];(1):1–10. Available from: https://doi.org/10.1136/bmjspcare-2021-002889.

Chitnis XA, Georghiou T, Steventon A, Bardsley MJ. Effect of a home-based end-of-life nursing service on hospital use at the end of life and place of death: A study using administrative data and matched controls. BMJ support. palliat. care (Online). [Internet]. 2013 [cited 2022 sep 5];3(4). Available from: https://doi.org/10.1136/bmjspcare-2012-000424.

Miranda B, Vidal SA, De Mello MJG, De Lima JTO, Rêgo JC, Pantaleão MC, et al. Cancer patients, emergencies service and provision of palliative care. Rev. Assoc. Med. Bras. (1954). [Internet]. 2016 [cited 2022 sep 5];62(3). Available from: https://doi.org/10.1590/1806-9282.62.03.207.

Seow H, Barbera L, Sutradhar R, Howell D, Dudgeon D, Atzema C, et al. Trajectory of performance status and symptom scores for patients with cancer during the last six months of life. J. clin. oncol. [Internet]. 2011 [cited 2022 sep 5];29(9). Available from: https://doi.org/10.1200/jco.2010.30.7173.

Barbera L, Taylor C, Dudgeon D. Why do patients with cancer visit the emergency department near the end of life? Cmaj. [Internet]. 2010 [cited 2022 sep 5];182(6). Available from: https://doi.org/10.1503/cmaj.091187

Seow H, Barbera L, Pataky R, Lawson B, O’Leary E, Fassbender K, et al. Does Increasing Home Care Nursing Reduce Emergency Department Visits at the End of Life? A Population-Based Cohort Study of Cancer Decedents. J. pain symptom manage. [Internet]. 2016 [cited 2022 jan 01];51(2). Available from: http://dx.doi.org/10.1016/j.jpainsymman.2015.10.008.

Verhoef MJ, de Nijs E, Horeweg N, Fogteloo J, Heringhaus C, Jochems A, et al. Palliative care needs of advanced cancer patients in the emergency department at the end of life: an observational cohort study. Support. care cancer. [Internet]. 2020 [Cited 2022 sep 5];28(3). Available from: https://doi.org/10.1007/s00520-019-04906-x.

Earle CC, Neville BA, Landrum MB, Ayanian JZ, Block SD, Weeks JC. Trends in the aggressiveness of cancer care near the end of life. J. clin. oncol. [Internet].

[cited 2022 sep 5];22(2). Available from: https://doi.org/10.1200/jco.2004.08.136.

Earle CC, Neville BA, Landrum MB, Souza JM, Weeks JC, Block SD, et al. Evaluating claims-based indicators of the intensity of end-of-life cancer care. Int J Qual Heal Care. [Internet]. 2005 [cited 2022 sep 5];17(6). Available from: https://doi.org/10.1093/intqhc/mzi061.

Soares LGL, Gomes R V., Palma A, Japiassu AM. Quality Indicators of End-ofLife Care Among Privately Insured People With Cancer in Brazil. Am J Hosp Palliat Med. [Internet]. 2020 [cited 2022 sep 5];37(8). Available from: https://doi.org/10.1177/1049909119888180.

Henson LA, Gomes B, Koffman J, Daveson BA, Higginson IJ, Gao W. Factors associated with aggressive end of life cancer care. Support. care cancer. [Internet]. 2016 [cited 2022 sep 5];24(3). Available from: https://doi.org/10.1007/s00520-015-2885-4.

Andersen SK, Croxford R, Earle CC, Singh S, Cheung MC. Days at home in the last 6 months of life: A patient-determined quality indicator for cancer care. J. oncol. pharm. pract. (Online). [Internet]. 2019 [cited 2022 sep 5];15(7). Available from: https://doi.org/10.1200/jop.18.00338.

Mendes K, Silveira R, Galvão C. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto enferm. [Internet]. 2008 [acesso em 05 de setembro 2022];17(4). Disponível em: https://doi.org/10.1590/S0104-07072008000400018.

Heinonen T, Loimu V, Saarilahti K, Saarto T, Mäkitie A. End-of-life care pathway of head and neck cancer patients: single-institution experience. Eur Arch Oto-Rhino-Laryngology. [Internet]. 2018 [cited 2022 jan 01];275(2). Available from: http://dx.doi.org/10.1007/s00405-017-4843-x.

Hsu HS, Wu TH, Lin CY, Lin CC, Chen TP, Lin WY. Enhanced home palliative care could reduce emergency department visits due to non-organic dyspnea among cancer patients: a retrospective cohort study. BMC palliat. care. [Internet]. 2021 [cited 2022 sep 5];20(1). Available from: https://doi.org/10.1186/s12904-021-00713-6.

Seow H, Sutradhar R, McGrail K, Fassbender K, Pataky R, Lawson B, et al. Endof-Life Cancer Care: Temporal Association between Homecare Nursing and Hospitalizations. J. palliat. med. [Internet]. 2016 [cited 2022 sep 5];19(3). Available from: https://doi.org/10.1089/jpm.2015.0229.

Mercadante S, Adil C, Caruselli A, Ferrera P, Costanzi A, Marchetti P, et al. The palliative-supportive care unit in a comprehensive cancer center as crossroad for patients’ oncological pathway. PLos ONE. [Internet]. 2016 [cited 202 sep 5];11(6). Available from: https://doi.org/10.1371/journal.pone.0157300.

Hjermstad MJ, Kolflaath J, Løkken AO, Hanssen SB, Normann AP, Aass N. Are emergency admissions in palliative cancer care always necessary? Results from a descriptive study. BMJ Open. [Internet]. 2013 [cited 2022 sep 5];3(5):e002515. Available from: https://doi.org/10.1136/bmjopen-2012-002515.

Kao YH, Liu YT, Koo M, Chiang JK. Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: A retrospective medical record study. BMC palliat. care. [Internet]. 2018 [cited 2022 sep 5];17(1). Available from: https://doi.org/10.1186/s12904-018-0302-8.

Gamblin V, Prod’homme C, Lecoeuvre A, Bimbai AM, Luu J, Hazard PA, et al. Home hospitalization for palliative cancer care: factors associated with unplanned hospital admissions and death in hospital. BMC palliat. care. [Internet]. 2021 [cited 2022 sep 5];20(1). Available from: https://doi.org/10.1186/s12904-021-00720-7.

Cornillon P, Loiseau S, Aublet-Cuvelier B, Guastella V. Reasons for transferral to emergency departments of terminally ill patients - A French descriptive and retrospective study. BMC palliat. Care. [Internet]. 2016 [cited 2022 jan 01];15(1). Available from: http://dx.doi.org/10.1186/s12904-016-0155-y.

De Korte-Verhoef MC, Pasman HRW, Schweitzer BP, Francke AL, OnwuteakaPhilipsen BD, Deliens L. End-of-life hospital referrals by out-of-hours general practitioners: A retrospective chart study. BMC fam. pract. [Internet]. 2012 [cited 2022 sep 5];13. Available from: https://doi.org/10.1186/1471-2296-13-89.

Salam-White L, Hirdes JP, Poss JW, Blums J. Predictors of emergency room visits or acute hospital admissions prior to death among hospice palliative care clients in Ontario: A retrospective cohort study. BMC palliat. care. [Internet]. 2014 [cited 2022 sep 5];13(1). Available from: https://doi.org/10.1186/1472-684x-13-35.

Gomes B, Higginson IJ. Factors influencing death at home in terminally ill patients with cancer: Systematic review. Br. med. j. [Internet]. 2006 [cited 2022 sep 5];332(7540). Available from: https://doi.org/10.1136/bmj.38740.614954.55.

Hennemann-Krause L, Lopes AJ, Araújo JA, Petersen EM, Nunes RA. The assessment of telemedicine to support outpatient palliative care in advanced cancer. Palliat. support care. [Internet]. 2015 [cited 2022 sep 5];13(4). Available from: https://doi.org/10.1017/s147895151400100x.

Silva VG da, Telles AC, Guimarães N de PA, Souza FN de, Campo LL, Bittencourt NCC de M, et al. A propulsão do teleatendimento no cuidado paliativo oncológico domiciliar durante a pandemia de COVID-19. Res Soc Dev. [Internet]. 2022 [acesso em 05 de setembro 2022];11(5):e35711528300. Disponível em: http://dx.doi.org/10.33448/rsd-v11i5.28300.

Mercadante S, Porzio G, Valle A, Aielli F, Costanzo V, Adile C, et al. Emergencies in patients with advanced cancer followed at home. J. pain symptom manage. [Internet]. 2012 [cited 2022 jan 01];44(2). Available from: http://dx.doi.org/10.1016/j.jpainsymman.2011.07.016.