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J Cyst Fibros. 2007 Nov 30;6(6):396-402. Epub 2007 May 3.

Effects of lung transplantation on inpatient end of life care in cystic fibrosis.

Author information

1
Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC 27599-7220, USA. epdellon@unch.unc.edu

Abstract

BACKGROUND:

The impact of lung transplantation on end of life care in cystic fibrosis (CF) has not been widely investigated.

METHODS:

Information about end of life care was collected from records of all patients who died in our hospital from complications of CF between 1995 and 2005. Transplant and non-transplant patients were compared.

RESULTS:

Of 38 patients who died, 20 (53%) had received or were awaiting lung transplantation ("transplant" group), and 18 (47%) were not referred, declined transplant, or were removed from the waiting list ("non-transplant"). Transplant patients were more likely than non-transplant patients to die in the intensive care unit (17 (85%) versus 9 (50%); P=0.04). 16 (80%) transplant patients remained intubated at or shortly before death, versus 7 (39%) non-transplant patients (P=0.02). Do-not-resuscitate orders were written later for transplant patients; 12 (60%) on the day of death versus 5 (28%) in non-transplant patients (P=0.02). Transplant patients were less likely to participate in this decision. Alternatives to hospital death were rarely discussed.

CONCLUSIONS:

Receiving or awaiting lung transplantation affords more aggressive inpatient end of life care. Despite the chronic nature of CF and knowledge of a shortened life span, discussions about terminal care are often delayed until patients themselves are unable to participate.

PMID:
17481967
PMCID:
PMC4394360
DOI:
10.1016/j.jcf.2007.03.005
[Indexed for MEDLINE]
Free PMC Article

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