Background and Objective: An Interdisciplinary Palliative Care Hospital Support Team (HST), run jointly by the Departments of Anaesthesiology, Oncology, and Neurology has been established at the Munich University Hospital since 1999. Aim of the study was to evaluate the range of patients supported, symptom prevalence, and the patients’ outcomes over a one-year period.
Methods: Files of all 462 patients followed by the HST in 2002, when no inpatient palliative care unit was available in our hospital, were retrospectively analysed. Data collection included demographic data, somatic symptoms, medication before and after involvement of the HST, psychosocial support, advance directives and outcome.
Results: Of 462 patients, 46.3% were male (average age 59.4 +/- 13.5 years). Patients were followed by the HST for an average of 9.4 +/- 9.0 days. 22.2% died during their hospitalisation, 30.2% were transferred to other facilities, and 47.6% could be discharged home. The referrals came from 15 different departments, most were from oncology, gastroenterology, neurology and surgery. Malignant diseases were the most common diagnosis (86.4%). Pain was the main reason for referral in 20.3%, while 27% reported no pain at all. 28.7% of patients showed significant neurological symptoms and/or had a primary neurological diagnosis. Advance directives were already present in 8.6%, were discussed with 15.3%, and completed by 4.3% of the patients.
Discussion: A high percentage of patients followed by the HST were able to return home in spite of their far-advanced diseases. Advance directives are an important area of work for our HST. The high prevalence of non-pain symptoms and neurological involvement supports the interdisciplinary approach adopted in our service.