Valoración global del control de síntomas al final de la vida

Objectives: to value the symptoms control at the end of the life of in patients in the Palliative Care Unit in the Chronic Hospital (medium and long staying). To know which is the degree of knowledge of the illness and which are the expectations and wishes of patients. Methods: retrospective study of in patients in the Palliative Care Unit in Malvarrosa Hospital, socio-demographics and clinics variables were collected. Results: 302 cases were studied, with an average of 69, dt-13. One hundred and seventy-nine out of them (59%) were men. Two hundreds and sixty-five of the Unit died (88%). The average staying was 26 days (dt 34). More of 50% of the patients were diagnosed of lung and gastro-intestinal tumours. One hundred and thirty-five (48%) presented bad prognosis pains. Cage test (alcoholism diagnostic) was positive in 28 patients (33%). The global evaluation of the symptoms control was good (that means, relaxed environment and symptoms and family situation acceptably controlled) in 210 patients (81%) and the situations bad controlled were basically: agitation, dispnea, vomitings, dead rattles and emotional distress. The mean of daily dose equivalent to the one of oral morphine was of 165 mg (medium 80 and dt: 263), being the more used opioids morphine en 98 cases (37%) and methadone in 56 (21%). Terminal sedation was made in 44 patients (17%). Euthanasia demand was made by 6 patients (2.5%) and one relative (0.4%). The knowledge of the illness and the prognosis was of 88 patients (35%). The acceptation of the situation by the ill patients was of 138 cases (57%). Conclusions: the measure of the symptoms was possible and well tolerated by the patients. The patients that we have studied presented a great number of symptoms. Alcoholism prevalence in our patients was bigger than in the general population. The demands of euthanasia were scarce. If we compare these results with international studies we can state that the knowledge of illness and its prognosis was smaller.