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Original research
Neuropalliative care in a tertiary-level hospital
  1. Diego Swerts1,
  2. Ana Araújo1,
  3. Polyana Vulcano1,
  4. Bernard Prado2,
  5. Caroline Miyake1,
  6. Rafael Docema1,
  7. Hye Hwang1 and
  8. Mario Peres1
  1. 1Department of Neurology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
  2. 2Palliative, Hospital Israelita Albert Einstein, Sao Paulo, Brazil
  1. Correspondence to Dr Diego Swerts, Neurology, Hospital Israelita Albert Einstein, 01222000 Santo Andre, Brazil; diegobelandrino{at}gmail.com

Abstract

Objectives Palliative care in neurology is a recent specialty to improve the quality of life of patients with severe neurological diseases. This study aims to determine the frequency of neurological inpatients who had indication of palliative care, and evaluate the symptomatology, demographic profile, the need for supportive measures, advance directives for life and medical history of patients in a tertiary hospital in Brazil.

Methods This cross-sectional analytical study evaluated all patients admitted to the neurological semi-intensive care unit (ICU) at Hospital Israelita Albert Einstein with neurological conditions from February through August 2022. The Palliative Performance Scale (weight loss greater than 5% associated with body changes and a negative response to the question: ‘Would you be surprised if the patient died within 1 year?’) was used to indicate palliative care. Patients were divided into three groups: patients with palliative care needs (groupindication), patients without palliative care needs (groupwithout indication) and patients who received at least one assessment of a palliative care team (grouppalliative). Demographic data were analysed using the Χ2 test for qualitative and Kruskal-Wallis test for quantitative variables.

Results Of the 198 patients included in the study, 115 (58%) had palliative care needs. Only 6.9% received assessment by the palliative care team, and 9.56% had advance directives in their medical records. Patients in groupindication had a higher prevalence of symptoms, such as fatigue, depression, shortness of breath and lack of appetite, and required more supportive measures, such as oxygen therapy, enteral/parenteral nutrition, admissions at ICU and days in hospital.

Conclusion Despite the high demand for palliative care in neurology, few patients receive this treatment, resulting in decreased quality of care. Therefore, greater integration and discussion of palliative care in neurology are needed.

  • neurological conditions
  • terminal care
  • symptoms and symptom management
  • prognosis
  • chronic conditions
  • advance directives

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/spcare-2023-004499

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors DS contributed to planning the article, data collection, statistical analysis, conducting and writing the article. PV contributed to coordinating the article, as well as organising the project. AA contributed to the coordination and writing of the article. CM contributed to data collection, as well as statistical analysis. RD contributed to data collection and writing the article. HH contributed to data collection and preparation of tables. MP contributed to the coordination, organisation, planning of the article, responsible for the overall content as the guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.