Despite their wishes, many patients die in hospitals or other facilities. Cardiovascular disease (HBV) is a leading cause of death both globally and in the United States, but little is known about where CKD patients die. In a new study, Hyder Worreich, Ph.D., from Brigham and Hospital Hospital, and colleagues evaluated the deaths of CKD patients from 2003 to 2017, finding that it exceeded the hospital's most common place of death for these patients at home. The results of their analysis are published in Journal of the American College of Cardiology.
"When I talk to my patients about what matters most to them as they begin to reach the end of their lives, many tell me that they want to spend their last moments surrounded by the closeness of home," said Voraich, who joined the ward for cardiovascular medicine at Brigham in September as an Associate Physician. "Understanding where patients die can help us determine how we can care for them and what services they will need in these settings."
To carry out their study, investigators examined more than 12 million deaths in multiple deaths at the National Public Health Mortality Mortality Report. They examined whether the deaths occurred in a hospital, home, nurse or long-term care facility, hospitalized or other (including outpatient medical facilities, emergency department and deadline hospital arrivals). They also analyzed demographic characteristics, including race, ethnicity, gender, marital status, level of education, and rural-urban status.
The team found that 330,905 HVB deaths occurred at the hospital in 2003, falling to 234,703 in 2017. Fatalities at home increased from 192,986 in 2003 to 265,133 in 2017, representing about 31% of HVB deaths. The team also found that unprotected racial and ethnic groups were more likely to die in hospital and less likely to die at home.
Voraic notes that while the data provide insights, they do not reveal how the last days or weeks of patients 'lives were and whether they were hospitalized at home, nor did the data capture patients' wishes and whether their place of death reflected those wishes.
"Cardiology is lagging behind other specialties in focusing on end-of-life care, but now we are seeing more interest in this important area," Voraic said. "We see more people dying at home than at any other location, but we need to better understand what the experience is like so we can focus our energy on our patients' needs."
The use of palliative care support is lagging behind in heart patients
Sarah F. Cross et al, Trends in Place of Death for Cardiovascular Diseases in the United States, Journal of the American College of Cardiology (2019). DOI: 10.1016 / j.jacc.2019.08.1015
More Patients With Cardiovascular Diseases Now Dying At Home Than In Hospital (2019, October 10)
Retrieved October 10, 2019
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