masterThesis
Factores pronóstico para hidratación medicamente asistida en pacientes con cáncer en seguimiento de cuidados paliativos en Bogotá
Autor
Garay Fernández, Javier
Institución
Resumen
Introduction: In the end-of-life process of a patient with an oncological condition, different events occur that demand close medical follow-up, in order to intervene in a timely manner and offer quality of life and comfort. However, even for the clinician it is difficult to determine the precise moment in which the patient enters a stage of total functional decline, in which intervention must be made to avoid risks of suffering and pain. For this reason, the identification of measurable variables that can help shape a prognostic model of the hydration requirement at the end of life will provide insight to the clinician and caregivers to offer additional tools for timely care. Objective: To determine a prognostic model for the requirement of medically assisted hydration in oncological patients from the home palliative care program. Methodology: Analytical retrospective observational cohort study of patients from the PHD Contigo program from August 2017 to December 2019. Patient follow-up from admission to the Contigo program until death was evaluated through a binary logistic regression model. defining the outcome variable as the requirement or not of artificial hydration. The independent variables found in the bivariate analysis were included, defined by their biology plausibility and relevance. The Generalized Estimation Equations (GEE) model was used given the characteristic of measuring variables in the same individual on several occasions in time. Conclusions: The determination of factors associated with the hydration requirement at the end of life provides opportunities for early and assertive care in the care of symptomatic control and quality of life. Monitoring for symptoms such as appetite, fatigue, and drowsiness; as well as the evaluation of certain tumors (gastrointestinal, gynecological and CNS) in the clinical context, will help guide the initiation of hydration in a timely manner.