Hospice Units as a requirement for terminal stage patients in need of intensive care in Turkey

Abstract

Background: Intensive care units (ICUs) are special units providing intensive observation, monitoring and supportive treatments, which can be applied as standardised and continuous patient care. Patients at the terminal stage of illness require monitoring in special units that are staffed by a multi-disciplinary team, which are known as a "hospice unit". In this study, we determined whether or not there is a need for a 'hospice unit'. Material and method: In this retrospective study, data for demographic characteristics, diagnoses, comorbidities, examination and laboratory findings were obtained from the emergency department patient records for each patient. Predicted mortality (PM) rates were calculated for each patient using the Acute Physiology and Chronic Health Evaluation (APACHE) II score and the Simplified Acute Physiology Score (SAPS) II score. The Surveillance, Epidemiology and End Results (SEER) grading score was used for grading the patients diagnosed with cancer. Results: We reviewed the records of patients presenting at the emergency department over a 1-year period and found that the majority (63.8%) of patients for whom tertiary level IC monitoring was recommended were over the age of 60 years, 20% had a diagnosis of advanced stage cancer and the predicted mortality rate was almost 60%. Conclusion: The establishment of hospice units in regional reference center would reduce the load on ICU and could be considered to partially resolve the problem of bed unavailability in ICUs.