Objective: To analyse the referral patterns of perinatal patients referred to a specialist palliative care service (SPCS), their demographics, diagnoses, duration of illness, place of death and symptom profile.
Design: A retrospective chart review of all perinatal referrals over a 4-year period to the end of 2015.
Setting: A consultant-led paediatric SPCS at Our Lady's Children's Hospital, Crumlin, Dublin, and the Coombe Women & Infants University Hospital, Dublin.
Results: 83 perinatal referrals were received in a 4-year period. Chromosomal abnormalities accounted for 35% of diagnoses, congenital heart disease 25%, complex neurological abnormalities 11% and renal agenesis 4%. 22 referrals (26.5%) were made antenatally, with 61 (73.5%) postnatally. Of the postnatal referrals, 27 (44%) were asymptomatic on referral. An opioid medication was recommended (regularly or as required) in 46 cases. Symptom control was achieved without dose titration in 43 of these cases (93%). Of 47 deaths in this group referred postnatally, 22 of these (47%) died at home with support from community teams. Discharge home for best supportive care required complex interagency communication and cooperation.
Conclusions: Perinatal palliative care requires effective multidisciplinary work, whether delivered in the inpatient setting or in the community. With appropriate support, end-of-life care can be delivered in the community.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1136/archdischild-2017-313183 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Multidisciplinary team meetings: dynamic routines that (re)make palliative care.
Health Sociol Rev
December 2024
Department of Anthropology, University of Amsterdam, Amsterdam, Netherlands.
Multidisciplinary team meetings are part of the everyday working life of palliative care staff. Based on ethnographic material from community and hospital palliative care teams in England, this article examines these meetings as dynamic routines. Although intended to have a prescribed format to review deaths and collect standardised information to monitor service performance, in practice, the content and conduct of the meetings were fluid, reflecting how this structure did not always match the concerns held by the team.
View Article and Find Full Text PDFOn TRacK With Larotrectinib in a Neonate With a Giant Congenital ETV6::NTRK3 Fusion-Positive Infantile Fibrosarcoma of the Head and Neck.
Head Neck
December 2024
Department of Pediatric Hematology & Oncology, Klinik für Kinder- Und Jugendmedizin, Universitätsmedizin Rostock, Rostock, Germany.
Background: Infantile fibrosarcoma (IFS) is a rare pediatric tumor of intermediate malignancy with high local aggressiveness that typically presents in young infants. Its occurrence in the head and neck region is rare. Complete non-mutilating surgical resection is often not possible, requiring multimodal treatment.
View Article and Find Full Text PDFCalciphylaxis: A Case Report and Review of the Role of Sodium Thiosulphate and Other Treatment Modalities.
Cureus
November 2024
Nephrology, Colchester Hospital, Colchester, GBR.
Calciphylaxis is a rare and serious disorder almost exclusively seen in patients on dialysis or those with advanced chronic kidney disease (CKD) not on dialysis and is associated with very high mortality. We present the case of a 50-year-old male with a background of end-stage renal disease (ESRD) compliant with dialysis, parathyroid adenoma, secondary hyperparathyroidism, and high body mass index (BMI). Whilst receiving 31 doses of intravenous sodium thiosulphate (STS) over an 11-week period, the patient underwent surgical debridement of multiple painful ulcerative lesions in his lower abdomen and left thigh and then subsequently a subtotal parathyroidectomy at 70 days from admission.
View Article and Find Full Text PDFDeveloping a novel transitional care model for older emergency department patients and exploring the target population in Taiwan.
Front Med (Lausanne)
December 2024
Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Aim: Transitional care in the emergency department (ED) has the potential to improve outcomes for older patients, but the specific population benefits from it and impact in Taiwan remain unclear. Therefore, we conducted this study.
Methods: An interdisciplinary team comprising emergency physicians, dedicated transitional care nurse (TCN), nurse practitioners, nurses, geriatricians, and social workers was established at a tertiary medical center.
Correlates of neurocognitive performance in older adults with chronic pain and negative emotions: baseline data from the problem adaptation therapy for pain (PATH-pain) randomized controlled trial.
Front Pain Res (Lausanne)
December 2024
Department of Psychiatry, Weill-Cornell Institute of Geriatric Psychiatry, Weill Cornell Medicine, White Plains, NY, United States.
Chronic pain is highly prevalent among older adults, is associated with cognitive deficits, and is commonly treated in primary care. We sought to document the extent of impairment across specific neurocognitive domains and its correlates among older adults with chronic pain in primary care. We analyzed baseline data from the Problem Adaptation Therapy for Pain trial, which examined a psychosocial intervention to improve emotion regulation in 100 adults ≥ 60 years with comorbid chronic pain and negative emotions, who did not have evidence of moderate-to-severe cognitive impairment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!