Korean J Hosp Palliat Care.  2023 Mar;26(1):7-17. 10.14475/jhpc.2023.26.1.7.

Decision and Practice of End-of-Life Care in Lung Disease Patients with Physicians Orders for Life Sustaining Treatment

• Oh YM
• Kang YN
• Han SJ
• Kim JH

• KMID: 2540098
• DOI: http://doi.org/10.14475/jhpc.2023.26.1.7

Abstract

Purpose
The purpose of this study was to analyze end-of-life care practices in lung disease patients with physician orders for life-sustaining treatment (POLSTs).
Methods
We retrospectively analyzed data from medical records regarding the end-of-life care practices of POLST decisions for patients with lung disease hospitalized at a tertiary hospital in Seoul, South Korea. Data were collected from January 1 to June 30, 2021.
Results
Of 300 total patients, 198 had lung cancer (66.0%) and 102 had non-malignant lung diseases (34.0%). A POLST was written for 187 patients (62.3%), and an advance directive was written for 20 patients (6.7%). Subsequent treatments were hemodialysis in 13 patients (4.3%), surgery in 3 patients (1.0%), and cardiopulmonary cerebral resuscitation in 1 patient (0.3%). Among cancer patients, chemotherapy was performed in 11 patients (3.7%), targeted therapy in 11 patients (3.7%), immunotherapy in 6 patients (2.0%), and radiation therapy in 13 patients (4.3%). Depending on the type of lung disease, types of treatment differed, including hemodialysis, ventilators, bilevel positive airway pressure, high-flow nasal cannulas, nebulizers, enteral nutrition, central line, inotropic agents, and opioids. onclusion: Although the goals of hospice care are the same whether a patient has lung cancer or a nonmalignant lung disease, because the characteristics of the respective diseases differ, end-oflife care practices and hospice approaches must be considered differently.

Keyword

Terminal care; Hospice care; Advance care planning; Personal autonomy; Lung diseases