New Israeli Law: Patients in End-of-Life and Actively Dying Condition – Possible
Human Suffering and Satisfaction Research Center, El-Ad, and Geriatric Division, The Chaim Sheba Medical Center, Tel Hashomer, Israel, E-mail: bechorz@yahoo.com
Key Words: dementia, end-of-life, critical illness, hospice, suffering, survival, mortality
Context: Six months of survival as a key criterion is extremely important for decision-making for enrolling critically ill patients to palliative settings.
Objective: Prospective cohort study with 6 months of follow-up during a 24-month period performed in Division of Geriatric Medicine in a tertiary general hospital.
Patients and methods: One-hundred and three consecutively admitted bedridden patients with end-stage dementia were evaluated. Patients were evaluated weekly by the scale (MSSE) which developed by us and presented in world and regional congresses in Berlin (1999), Jerusalem (2000), Vancouver (2001), Stockholm (2002), Tokyo (2003), , Las-Vegas (2004), Rio-de-Janeiro (2005), Madrid (2006), Saint-Petersburg (2007), the Committee for Labor, Social Services and Health of the Israeli Knesset (2005) and published in Journal Archives of Gerontology and Geriatrics (2004, 38, 2, 123-130) and Age and Ageing (2006, 35, 6, 597-601) and our book – Measurement of Suffering in end-stage Alzheimer’s Disease, Dyonon, Tel-Aviv,2007.
Interrelations between score at admission and six month’s survival and mortality were evaluated.
Results: A significant difference was proved among survival curves of subgroups of patients according to the mini scores (0-3, 4-6, 7-10). Survival was shorter and mortality higher in patients with a high score, as shown by the Kaplan-Meier method using the Log Rank (p=0.001) and Breslow tests (p=0.001).
Conclusion: The scale is useful for predicting the last 6 months of survival and mortality of end-stage dementia patients.