Repeated radiological procedures in the last 6 months of life in old age: a retrospective study.

IF 2 4区医学 Q3 HEALTH CARE SCIENCES & SERVICES BMJ Supportive & Palliative Care Pub Date : 2024-08-27 DOI:10.1136/spcare-2024-005078

Joseph Hawkins, Sam Beardsmore-Rust, Myra Adra, Zoe Halford

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Abstract

Objectives: This novel study looks at the use of radiological procedures in an elderly cohort of patients in their last 6 months of life. Radiological imaging plays a central part of clinical investigations, but too many may override the judgement of benefits, risks and resources. There is little information on the burden of radiological procedures performed towards the end of life in patients of old age.

Methods: Data from every fourth patient aged 80 years and over who died between 4 July 2021 and 30 December 2021 in a National Health Service (NHS) hospital were collected. All radiological procedures performed within the last 6 months of the patients' life were recorded from clinical documentation and related to their age.

Results: 96 patients were studied with a total of 699 radiological procedures performed. When scaled up, costs of CT and MRI scans alone are conservatively estimated as £312 000/annum in patients aged ≥80 years in their last 6 months of life for a single medium-sized NHS hospital.

Conclusions: A very large number of radiological procedures were performed towards the end of life among patients of old age. This is consistent with the national trend of increased medicalisation and poor recognition of dying.

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老年患者在生命最后 6 个月内重复接受放射治疗：一项回顾性研究。

研究目的这项新颖的研究调查了老年患者群体在生命最后 6 个月中使用放射程序的情况。放射成像是临床检查的核心部分，但过多的放射成像可能会影响对效益、风险和资源的判断。有关老年患者在生命最后阶段进行放射检查的负担的信息很少：方法：收集 2021 年 7 月 4 日至 2021 年 12 月 30 日期间在国民健康服务（NHS）医院死亡的 80 岁及以上患者的数据。根据临床文件记录了患者生命最后 6 个月内进行的所有放射手术，并将其与患者的年龄联系起来：96 名患者接受了研究，共进行了 699 次放射治疗。在一家中型 NHS 医院中，年龄≥80 岁的患者在生命最后 6 个月内进行 CT 和 MRI 扫描的费用保守估计为 31.2 万英镑/年：结论：老年患者在生命的最后阶段接受了大量的放射治疗。结论：老年患者在生命末期接受了大量放射治疗，这与全国医疗化程度提高和对死亡认识不足的趋势是一致的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Supportive & Palliative Care Medicine-Medicine (miscellaneous)

CiteScore

4.60

自引率

7.40%

发文量

170

期刊介绍： Published quarterly in print and continuously online, BMJ Supportive & Palliative Care aims to connect many disciplines and specialties throughout the world by providing high quality, clinically relevant research, reviews, comment, information and news of international importance. We hold an inclusive view of supportive and palliative care research and we are able to call on expertise to critique the whole range of methodologies within the subject, including those working in transitional research, clinical trials, epidemiology, behavioural sciences, ethics and health service research. Articles with relevance to clinical practice and clinical service development will be considered for publication. In an international context, many different categories of clinician and healthcare workers do clinical work associated with palliative medicine, specialist or generalist palliative care, supportive care, psychosocial-oncology and end of life care. We wish to engage many specialties, not only those traditionally associated with supportive and palliative care. We hope to extend the readership to doctors, nurses, other healthcare workers and researchers in medical and surgical specialties, including but not limited to cardiology, gastroenterology, geriatrics, neurology, oncology, paediatrics, primary care, psychiatry, psychology, renal medicine, respiratory medicine.