Table 1

Goals of care that were not achieved during first 4 hours episode after the start of the CPD and the last 4 hours episode prior to death, per setting

SymptomHospital
N=1252
LTC
N=449
Hospice
N=1086
First 4 hours episode after start CPDLast 4 hours episode prior deathFirst 4 hours episode after start CPDLast 4 hours episode prior deathFirst 4 hours episode after start CPDLast 4 hours episode prior death
Patient has no pain262 (20.9)140 (11.2) p<0.00167 (14.9)42 (9.4) p<0.001143 (13.2)79 (7.3) p=0.005
Patient is not restless274 (21.9)179 (14.3) p<0.00166 (14.7)53 (11.8) p=0.198187 (17.2)101 (9.3) p<0.001
Patient has no obstruction of breath by respiratory tract secretions103 (8.2)97 (7.8) p=0.67921 (4.7)44 (9.8) p<0.00153 (4.9)56 (5.2) p=0.826
Patient has no nausea49 (3.9)14 (1.1) p<0.00115 (3.3)6 (1.3) p=0.04914 (1.3)5 (0.5) p=0.022
Patient is not vomiting31 (2.5)16 (1.3) p=0.0148 (1.8)4 (0.9) p=0.34413 (1.2)10 (0.9) p=0.629
Patient is not short of breath236 (18.9)134 (10.7) p<0.00124 (5.3)14 (3.1) p=0.06459 (5.4)26 (2.4) p<0.001
At least one of these goals was not achieved536 (42.8)337 (26.9)
p<0.001
137 (30.5)112 (24.9)
p=0.040
310 (28.5)190 (17.5)
p<0.001
  • All p values are derived from McNemar test to assess the statistical significance of differences between the first and last 4 hours episode.

  • Differences between settings were considered statistically significant with p≤0.005.

  • CPD, Care Programme for the Dying.