Campos-Calderón, CMontoya-Juárez, RHueso-Montoro, CHernández-López, EOjeda-Virto, FGarcía-Caro, M P2016-11-152016-11-152016-11-07Campos-Calderón C, Montoya-Juárez R, Hueso-Montoro C, Hernández-López E, Ojeda-Virto F, García-Caro MP. Interventions and decision-making at the end of life: the effect of establishing the terminal illness situation. BMC Palliat Care. 2016 ; 15(1):91http://hdl.handle.net/10668/2524Journal Article;The study was approved by the ethics committee of Hospital Clínico San Cecilio, Hospital Virgen de las Nieves, Hospital Comarcal de Baza, Hospital Santa Ana de Motril (PI-0670-2010).BACKGROUND Many 'routine' interventions performed in hospital rooms have repercussions for the comfort of the patient, and the decision to perform them should depend on whether the patient is identified as in a terminal phase. The aim of this study is to analyse the health interventions performed and decisions made in the last days of life in patients with advanced oncological and non-oncological illness to ascertain whether identifying the patient's terminal illness situation has any effect on these decisions. METHODS Retrospective study of the clinical histories of deceased patients in four hospitals in Granada (Spain) in 2010. Clinical histories corresponding to the last three months of the patient's life were reviewed. RESULTS A total of 202 clinical histories were reviewed, 60 % of which were those of non-oncology patients. Opioid prescriptions (58.4 %), palliative sedation (35.1 %) and Do Not Resuscitate (DNR) orders (34.7 %) were the decisions most often reflected in the histories, and differences in these decisions were found between patients registered as terminal and those who were not registered as terminal. The most frequent interventions in the final 14 days and 48 h were parenteral hydration (96-83 %), peripheral venous catheter (90.1-82 %) and oxygen therapy (81.2-70.5 %). There were statistically significant differences between the patients who were registered as terminal and those not registered as terminal in the number of interventions applied in the final 14 days and 48 h (p = 0.01-p = 0.00) and in many of the described treatments. CONCLUSION The recognition of a patient's terminal status in the clinical history conditions the decisions that are made and is generally associated with a lower number of interventions.enDecision makingDelivery of careEnd-of-life careHospital carePrognosisSymptom managementAnalgésicos opioidesHospitalesHumanosOxígenoPrescripcionesÓrdenes de resucitaciónEstudios retrospectivosEspañaAndalucíaMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Sensory System Agents::Analgesics::Analgesics, OpioidMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::HospitalsMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Chemicals and Drugs::Inorganic Chemicals::Elements::Chalcogens::OxygenMedical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Pharmaceutical Services::PrescriptionsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Emergency Treatment::Resuscitation::Resuscitation OrdersMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective StudiesMedical Subject Headings::Geographicals::Geographic Locations::Europe::Spainresearch article27821105open access10.1186/s12904-016-0162-z1472-684X