Læknablaðið - 01.05.2017, Page 16

228 LÆKNAblaðið 2017/103
R A N N S Ó K N
ENGLISH SUMMARY
Introduction: The purpose of this study was to evaluate the frequency
of 5 common symptoms and drug treatments prescribed and given in
the last 24 hours of life in 11 medical units at Landspitali National Uni-
versity Hospital of Iceland (LUH) and in 7 nursing homes (NH).
Material and methods: Data was collected retrospectively from 232
charts of patients who died in 2012, using documentation in the Liver-
pool Care Pathway (LCP) and the medication management system.
Results: About half of the patients died at LUH with similar gender ratio
but 70% of patients in NH were women. The LCP was used for 50% of
all deaths at LUH and 58% in NH. In 45% of all deaths LCP was used
for 24 hours or less. The most common symptoms were pain (51%),
agitation (36%) and respiratory tract secretions (36%). Frequency of
symptoms was similar between institutions and age groups. Cancer
patients had significantly higher incidence of agitation and were prescri-
bed and given higher doses of morphine compared to other groups.
Regular medication for agitation was haloperidol (45%), diazepam (40%)
and midazolam (5%). Close to 70% of the patients were treated with a
scopolamin patch for death rattle.
Conclusion: A large number of patients have symptoms in the last 24
hours of life both in hospital and in nursing homes. Symptom control
can be improved by adjusting morphine doses to patients need,
using regular doses of benzodiazepine for agitation and better use of
anticholinergic medication for death rattle.
Frequency of symptoms and drug treatment among dying patients in the last 24 hours of life at Landspitali
– The National University Hospital of Iceland and in nursing homes
Svandís Íris Hálfdánardóttir1, Kristín Lára Ólafsdóttir2, Valgerður Sigurðardóttir1,2,3
1Palliative Care Unit, 2Hospital based Palliative Care Consulting Team, 3Palliative Home Care Team.
Key words: symptoms, medication, dying patients, last 24 hours of life, hospital, nursing homes.
Correspondence: Svandís Íris Hálfdánardóttir, svaniris@landspitali.is
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