Palliative Care in Primary and Metastatic Brain Tumors

Öz

Introduction: Early palliative care interventions and structured advance care planning can improve symptom control and quality of life in patients with a brain tumor. In this study, we aimed to investigate symptoms, hospital discharge conditions, and the length of stay of patients with primary and metastatic brain tumors in our palliative care center (PCC). Material and Method: Ninety-one patients; who had been followed-up in the PCC with the diagnosis of a primary or metastatic brain tumor were included in this retrospective study. Demographic characteristics, Glasgow Coma Scale (GCS) scores, Karnofsky Performance Scale (KPS) scores, hospital discharge status, and symptoms of the patients included in the study were compared. Results: The mean age of the patients was 60.67 years; 59.3% were male, and the mean length of hospital stay was 29.26 days. The rates of PEG, tracheostomy, seizures, and paresis symptoms were significantly higher in patients with a primary brain tumor (p<0.05). The rates of death in the hospital were significantly higher in patients with metastatic tumors and low GCS scores (p=0.032 and p=0.00, respectively). Conclusion: We observed differences in clinical findings and prognoses between primary and metastatic brain tumor patients during the follow-up in PCC. Further to advances in treatment methods, we believe that identifying the need for palliative care and appropriate symptom management will improve the quality of life in brain tumor patients with poor prognosis.

Anahtar Kelimeler

• : Brain tumors
• palliative care
• discharge status
• seizure

Primer ve Metastazik Beyin Tümörlerinde Palyatif Bakım

Öz

Giriş: Erken Palyatif bakım müdahaleleri ve yapılandırılmış ileri bakım planlaması, beyin tümörü hastalarında semptom kontrolünü ve yaşam kalitesini artırabilir. Bu çalışmada palyatif bakım merkezimizde (PBM) primer ve metastatik beyin tümörü tanısı alan hastaların semptomlarını, çıkış durumlarını ve yatış sürelerini araştırmayı amaçladık. Gereç ve Yöntem: Bu retrospektif çalışmada palyatif bakım servisinde primer ve metastatik beyin tümörü tanısı ile izlenen 91 hasta alındı. Çalışmaya alınan hastaların demografik özellikleri, glaskow koma skalası (GCS), Karnofsky Performans Skalası (KPS), çıkış durumu, hastanede yatış süresi ve semptomları karşılaştırıldı. Bulgular: Hastaların yaş ortalaması 60,67 yıldı, %59,3’ü erkekti ve yatış süreleri ortalama 29,26 gündü. Primer beyin tümörü olan hastalarda PEG, trakeostomi durumu ve nöbet, parezi semptomu oranları anlamlı derecede fazla idi. (p<0,05) Metastatik tümörü olanlarda ve GCS düşük olanlarda çıkış durumu exitus olanlar anlamlı derecede fazla idi.(p=0,032, p=0,00) Sonuç: Primer ve metastatik beyin tümörü olan hastaların palyatif bakımda izlemleri sırasında bulgularında ve klinik prognozlarında farklılıklar olduğu gördük. Tedavilerdeki ilerlemelere rağmen zayıf prognoza sahip beyin tümörlerinin palyatif bakım ihtiyaçlarının belirlenip, semptomların iyi yönetilmesinin, bu hastalarda yaşam kalitesini artıracağını düşünüyoruz.

Anahtar Kelimeler

• Beyin tümörleri
• palyatif bakım
• çıkış durumu
• nöbet

Kaynakça

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