Therapeutic Intervention Code in a Cognitive Geriatric Unit

Completed

• Conditions: Cognitive Impairment
• Interventions: Other: Medical File consultation

• Registration Number: NCT03408028
• Lead Sponsor: Murielle Surquin

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

Detailed Description

Not available

Study Timeline

• Study Start: 2017-04-01
• Primary Completion: 2017-10-01
• Study Completion: 2017-10-01
• Status Verified: 2018-01
• Study First Submitted: 2018-01-17
• Study First Submitted QC: 2018-01-17
• Last Update Submitted: 2018-01-17
• Study First Posted: 2018-01-23
• Last Update Posted: 2018-01-23

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 310

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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Cognitive impairment	Medical File consultation	Geriatric patients with a cognitive impairment

Primary Outcome Measures

Name	Time	Method
Cumulative Illness Rating Scale for Geriatrics	From 01-01-2016 till 31-12-2016	This scoring system measures the chronic medical illness ("morbidity") burden while taking into consideration the severity of chronic diseases in 14 items representing individual body systems. The cumulative final score can theoretically vary from 0 to 56.
Therapeutic code	From 01-01-2016 till 31-12-2016	Therapeutic code

Secondary Outcome Measures

Name	Time	Method
Age	From 01-01-2016 till 31-12-2016	Age
Sex	From 01-01-2016 till 31-12-2016	Sex
Ethnicity	From 01-01-2016 till 31-12-2016	Ethnicity

Trial Locations

Locations (1)

CHU Brugmann; 🇧🇪 Brussels, Belgium