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Original Article
Clinical characteristics of patients discharged from a palliative care center to home care: a retrospective cross-sectional study
Aims: The aim of this study was to establish the clinical characteristics and their impact on the length of stay (LOS) of patients discharged from a palliative care center (PCC) to home care (HC).
Methods: Our cross-sectional study retrospectively analysed 314 patients who were discharged from PCC to HC between 1 January 2015 and 30 September 2018. The patients were divided into two groups based on their LOS in the PCC. Prolonged hospitalisation was defined as hospitalisation for more than 30 days. Clinical characteristics associated with prolonged hospitalization were analyzed.
Results: The study included 314 patients, with 129 (41.08%) female and 185 (58.92%) male. The mean age was 68.41±18.91 years and the LOS in PCC was 36.27±40.34 days. Of the patients, 186 were hospitalized for 30 days or less, while 128 were hospitalized for more than 30 days. The most frequent diagnosis was cerebrovascular event (CVE) (37.57%). The most common accompanying chronic systemic diseases were hypertension (20.70%), followed by diabetes mellitus and heart failure (9.87%; 6.68%, respectively). Out of the total number of patients, 9.87% (n=31) were mobilized. Among them, 55.09% (n=173) were able to receive oral nutrition, 42.03% (n=132) had percutaneous endoscopic gastrostomy (PEG), 23.88% (n=75) had pressure ulcer (PU), and 27.07% (n=85) had tracheostomy. Additionally, 6.68% (n=24) of the patients were receiving respiratory support with a home ventilator. It was observed that the LOS of patients who were mobile, able to feed orally, and diagnosed with cancer was shorter. The presence of CVE (p=0.001), head trauma (p=0.013), hypoxic brain diagnosis (p=0.001), PEG (p<0.001), tracheostomy (p<0.001), PU (p=0.011), and home ventilator (p=0.024) were identified as predictors of long LOS. Hypoxic brain diagnosis was found to be the clinical feature most strongly associated with long-term hospitalization (OR:6.8), followed by PEG feeding (OR:6.6) and the presence of tracheostomy (OR:5.2).
Conclusion: In our study we observed that time to discharge is extended due to training on care and nutrition for patients undergoing tracheostomy, PEG and PU.

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Volume 6, Issue 2, 2024
Page : 155-160