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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 2/2022

04.03.2022 | Original Contributions

Terminal care in oldest old dying from COVID-19 in the acute hospital

A multicenter study describing pharmacological treatment in the last 24 h

verfasst von: M.D. Wim H. Janssens, MD, PhD Nele J. Van Den Noortgate, MD, PhD Ruth D. Piers

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 2/2022

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Abstract

Background

Coronavirus disease 2019 (COVID-19) has a high mortality, especially in the oldest old. Dying from COVID-19 is often characterized by symptoms such as breathlessness and agitation but data concerning medical treatment in the dying phase are limited.

Objective

This study describes the administration of oxygen, opioids and benzodiazepines in the last 24 h before death in patients 80 years or older dying from COVID-19 on acute hospital wards.

Material and methods

In this multi-centric retrospective study, patients, 80 years and older, admitted to the acute hospital in March and April 2020 were recruited from 10 acute Belgian hospitals. They all were diagnosed with COVID-19 and died on non-ICU wards with COVID-19. Administration of oxygen, opioids and benzodiazepines in the last 24 h before death was registered.

Results

Eighty-five percent of patients received oxygen, half of them even by means of a mask providing at least 10l oxygen per minute. The majority (84.3%) of patients were treated with opioids (morphine). Mean dosage of SC morphine equivalent was 31.3 mg/24 h (range 2–120 mg; SD 21.6 mg). More than half of patients (52.8%) received benzodiazepines, mostly midazolam. Mean dosage of midazolam was 20.4 mg/24 h (range 1–100 mg; SD 15.4 mg). Dosages of morphine and midazolam did not differ depending on frailty or comorbidities. Older COVID-19 patients dying with respiratory failure had higher midazolam dosage (p 0.002) but not morphine dosage (p 0.11).

Conclusion

A high proportion of patients 80 years and older and dying with COVID-19 in the hospital, were treated with oxygen, opioids and benzodiazepines in the last 24 h before death. With this descriptive study, we hope to contribute to the discussion and further research on the optimization of symptom control in an older population dying from/with COVID-19.

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Literatur
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Zurück zum Zitat Bailey FA, Williams BR, Goode PS et al (2012) Opioid pain medication orders and administration in the last days of life. J Pain Symptom Manag 44:681–691 CrossRef Bailey FA, Williams BR, Goode PS et al (2012) Opioid pain medication orders and administration in the last days of life. J Pain Symptom Manag 44:681–691 CrossRef
Metadaten
Titel
Terminal care in oldest old dying from COVID-19 in the acute hospital
A multicenter study describing pharmacological treatment in the last 24 h
verfasst von
M.D. Wim H. Janssens
MD, PhD Nele J. Van Den Noortgate
MD, PhD Ruth D. Piers
Publikationsdatum
04.03.2022
Verlag
Springer Medizin
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 2/2022
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-022-02036-4