How people die in hospital general wards: A descriptive study

To describe how patients die in hospital, 3 70 Patients (age > 18 years; in hospital for > 24 hours) who died on the general wards of 40 Italian hospitals were assessed. Differences between patients whose death was expected and patients whose death was unexpected were evaluated. Data on treatments and care in proximity of death were collected after interviewing the nurse responsible for the patient within 72 hours of the patient's death, and from clinical and nursing records. For 58% of patients, death was highly expected. Symptom control was inadequate for the most severely ill patients: 75% experienced at least one severe symptom (42% pain and 45% dyspnea). Nurses tended to budge patients' global care as good or very good (76%), in spite of the Persistence of symptoms and the scant use of analgesics. Despite some encouraging signs of sensitivity to end-of-life problems, acute inpatient institutions in Italy still deal inadequately with the needs of dying persons. (c) 2005 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.