Clinical Experience of Hypodermoclysis in Elderly Patients at the End of Life in a Long-term Care Unit

Abstract

We report our clinical experience of hypodermoclysis (HDC) in elderly patients at the end of life in a long-term care unit. The subjects were 92 patients who died during hospitalization in the long-term care unit between the 2007 and 2010. The underlying conditions included cerebrovascular disease in 48 cases (52.2%), dementia in 11 cases (12%), and malignant tumor in 5 cases (5.4%). The patients were divided into the HDC group (24 cases) and the intravenous infusion (IV) group (68 cases), and the duration of infusion, infusion dose, and clinical progress were compared retrospectively. The median age was 85 years in the HDC group and 84 years in the IV group. Dementia was common in the HDC group, and the two groups did not differ significantly with respect to the cause of death. The duration of infusion was 36.5 (5-107) days in the HDC group and 34.5 (3-158) days in the IV group, with no significant difference between the groups. The infusion dose was 500 (250-700) ml/day in the HDC group and 750 (500-1200) ml/day in the IV group, with the dose being significantly lower in the HDC group. Peripheral edema was evident in 9 cases (37.5%) in the HDC group and 39 cases (57.4%) in the IV group, with no significant difference between the groups. There were no adverse events in either group. Intravenous catheterization was difficult in 10 cases, and consequently, these patients were shifted to HDC. HDC exhibited the same life-prolonging effects and safety as IV in elderly patients at the end of life in the long-term care unit.