OLDER ADULTS FUNCTIONAL STATUS AND SYMPTOM BURDEN IN THE LAST 12MONTHS OF LIFE
Dr AM KHALIL1, Dr LOUISE PURTELL1,2, Ms LAURA AUSTIN1, Ms ILSE BERQUIER1, Professor ANN BONNER1,3, Dr HELEN HEALY1,4, Dr KIRSTEN HEPBURN1,4
1Kidney Health Service, Metro North Hospital and Health Service, Brisbane, , 2Research Development Unit, Caboolture Hospital, Caboolture, Australia, 3School of Nursing and Midwifery, Griffith University, Southport, Australia, 4Faculty of Medicine, University of Queensland, Herston,
Aim: To examine symptom burden and functional status of older people with advanced kidney disease known to a kidney supportive care (KSC) service in the last 12months of life.
Background: People with advanced kidney disease, particularly older people, have high symptom burden and mortality. KSC services aim to address palliative care needs in this cohort.
Methods: Retrospective analysis of adults ≥75years who died between February 2017 and March 2024 and had been reviewed by KSC in the 12months prior to death. Demographics, disease data and treatment pathway were extracted from the medical records. Resource Utilisation Group Activities Daily Living (RUG-ADL), Australia-modified Karnofsky Performance Status (AKPS) and integrated Palliative Care Outcome Scale for Renal patients (IPOS-Renal) at 12months and 3months prior to death were also extracted.
Results: Ninety-one people, 41.8% female, were included. At referral, mean age was 82.2years (SD 4.4), and 70.3% were on a conservative pathway. Mean eGFR at referral was 14.4ml/min/1.73m2 (SD 7.1ml/min/1.73m2).
50 people had RUG-ADL recorded at both time points. Compared with 12months prior to death, median RUG-ADL was higher 3months prior to death (4 v 6, p=0.004). Median AKPS was lower 3months compared to 12months prior to death (51.1 v 56.9, p<0.001) in the 52 patients with recorded data. Only 38 people had IPOS-renal at both time points, nonetheless there was no significant difference in IPOS-Renal scores at 12months compared to 3months prior to death (19 v 18.8, p=0.914).
Conclusions: As expected, functional status declined closer to death. However, symptom burden remained stable in the last 12months of life likely indicating benefit of KSC in this cohort. Larger, prospective studies are required to further expand on trends described.
Biography:
Dr Abdul Mueez Khalil is a Senior House Officer at the Royal Brisbane and Women’s Hospital. He is currently on the Basic Physician Training pathway in hopes of pursuing a career in nephrology.