Clinical trial NCT03408028: Therapeutic Intervention Code in a Cognitive Geriatric Unit
Official title: Therapeutic Intervention Code in a Cognitive Geriatric Unit: Retrospective Analysis
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Cognitive Impairment
Keywords: Therapeutic code
Geriatry
Lead sponsor: Brugmann University Hospital
Sponsor class: OTHER
First posted: 2018-01-23
Enrollment: 310
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Eldelry patients with cognitive imparement admitted in the geriatric unit 83 within the CHU Brugmann between 01-01-2016 and 31-12-2016.

Brief summary: The diagnostic and therapeutic progresses, associated with modifications in lifestyle and socio-cultural level of populations, have led to a remarkable increase in life expectancy. At the same time, the increasing medicalization of the individual has eroded the traditional boundaries between health and illness, normal and pathological state. This leads to the patient losing his sense of ownership of his own death. If most patients died at home before the Second World War, 75% of the population dies in hospital or institution at the present date.

Most hospitals and care institutions have developed codes, in multidisciplinary internal consultation, to address the interruption or lack of implementation of treatments that make no sense from a medical point of vue. This avoids therapeutic relentlessness.The code in place within the CHU Brugmann is:

* code A: no therapeutic restriction
* code B: not to be resuscitated
* code C: not to be intensively treated (no escalation in therapeutic treatments)
* code D: best palliative care (progressive de-escalation in therapeutic treatments).

These codes are established in consultation with the patient or his legal representative and are re-evaluated in a multidisciplinary way every week.

Planning a care path and therefore establishing a therapeutic code is particularly important for people with cognitive impairment and dementia because the progressive loss of cognitive abilities complicates the process of decision making.

A large part of the admissions are made via the emergency department. For these patients, no therapeutic plan has been established beforehand. However, the perception of the functional and cognitive status of the patient directly influences the intensity of care provided. Cognitive disorders are a risk factor for the exclusion of access to palliative care for the elderly patient.

The objectives of this study are:

* To establish a record of the therapeutic limitation codes in an acute cognitive geriatric unit
* To correlate the therapeutic limitation code with the comorbidities of the patients


Eligibility criteria: Inclusion Criteria:

Elderly patients with cognitive impairment admitted in the geriatric unit 83 within the CHU Brugmann between 01-01-2016 and 31-12-2016.

Exclusion Criteria:

None

Primary outcomes:
measure: Therapeutic code
timeFrame: From 01-01-2016 till 31-12-2016
measure: Cumulative Illness Rating Scale for Geriatrics
timeFrame: From 01-01-2016 till 31-12-2016
Secondary outcomes:
measure: Age
timeFrame: From 01-01-2016 till 31-12-2016
measure: Sex
timeFrame: From 01-01-2016 till 31-12-2016
measure: Ethnicity
timeFrame: From 01-01-2016 till 31-12-2016
Other outcomes:
Locations:
city: Brussels
country: Belgium
facility: CHU Brugmann
Study officials:
affiliation: CHU Brugmann
name: Carolina Natalia Grande Pérez, MD
role: PRINCIPAL_INVESTIGATOR
References: