Shared decision-making at end-of-life is aided by graphical trending of illness severity.
BMJ Case Rep
; 20142014 Jan 13.
Article
em En
| MEDLINE
| ID: mdl-24419639
ABSTRACT
The Rothman Index (RI) gives a visual picture of patient's condition and progress for the physician and family to view together. This case demonstrates how the RI graph facilitates physician-family communication. An 85-year-old man with normal pressure hydrocephalus and ventriculoperitoneal shunt presented with a subdural haematoma. He required a temporoparietal craniotomy and evacuation of left subdural haematoma, followed by care in an intensive inpatient rehabilitation unit. His course was complicated by aspiration pneumonia, dehydration, renal failure and phenytoin toxicity. During hospitalisation, the patient's RI graph was reviewed daily with his family. The RI provided an unambiguous visualisation of the trend of patient acuity, which depicted the patient's persistent decline in health, and made clear to the family the situation of the patient. This clarity was instrumental in prompting frank discussions of prognosis and consideration of comfort measures, resulting in timely transfer to hospice.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
4_TD
Problema de saúde:
4_pneumonia
Assunto principal:
Gráficos por Computador
/
Cuidados Paliativos na Terminalidade da Vida
/
Comunicação
/
Tomada de Decisões
/
Gravidade do Paciente
Tipo de estudo:
Prognostic_studies
Aspecto:
Patient_preference
Limite:
Aged80
/
Humans
/
Male
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Estados Unidos