Onkologija
Not a member yet
431 research outputs found
Sort by
Protibolečinsko obsevanje kostnih zasevkov
Get PDFBone metastases cause pain and impair quality of life, and they can lead to serious complications that require immediate treatment. Urgent surgical treatment followed by postoperative radiotherapy should be considered in bone metastases with an impending or existing pathologic fracture or spinal cord compression. Patients who are unable or unwilling to undergo surgery should be referred for urgent radiotherapy. Patients with painful bone metastases without an impending or existing pathologic fracture and no spinal cord compression, regardless of the size of the metastatic lesion, are treated pharmacologically first, complemented by palliative irradiation. In palliative radiation, low total doses are prescribed and delivered in a single fraction or in short fractionation regimens. Patients with insufficient pain relief or pain relapse after initial radiation can be safely reirradiated. We conducted a retrospective review of palliative bone irradiations between 2018 – 2021 at the Institute of Oncology Ljubjana. Annually, we treat 800 bone metastases and we are seeing a decline in the number of irradiations. The most common fractionation is 5 x 4 Gy, with only 10% of patients receiving single-dose treatment. Palliative irradiation for painful bone metastases is effective, inexpensive, and safe. It is critical to select patients who will benefit from radiation therapy and present them in a multidisciplinary team meeting. Radiation treatment can be made easier to use by simplifying the procedure for the patient and prescribing the dose in one fraction.Kostni zasevki povzročajo bolečino, ki vpliva na kakovost življenja bolnika in lahko vodijo do zapletov, ki zahtevajo urgentno ukrepanje. Ko zaradi kostnih zasevkov grozi oziroma je prisoten patološki zlom ali maligna kompresija hrbtenjače, je nujno oceniti, ali bolnik potrebuje kirurško intervencijo, ki ji sledi pooperativno obsevanje. Kadar bolnik ni kandidat za operativno zdravljenje, se priporoča urgentno obsevanje. Pri bolečih kostnih zasevkih, brez grozečega oziroma prisotnega patološkega zloma ali maligne utesnitve hrbtenjače, ne glede na velikost samega zasevka, prvi pristop zdravljenja bolečine predstavlja farmakološko zdravljenje, ki ga podpre in dopolni protibolečinsko paliativno obsevanje. Pri paliativnem obsevanju so celokupne obsevalne doze nizke, obsevanje je izvedeno v enem odmerku ali v kratkih obsevalnih režimih. Bolniki, ki ne odgovorijo na prvo obsevanje, ali se jim bolečina ponovi, so lahko varno ponovno obsevani na istem mestu. Na Onkološkem inštitutu Ljubljana smo opravili retrospektivni pregled paliativnih obsevanj kosti med leti 2018 – 2021. Letno obsevamo 800 kostnih zasevkov, upažamo pa upad števila obsevanj. Najpogostejša frakcionacija je 5 x 4 Gy, samo 10% bolnikov pa prejme obsevanje v enem odmerku. Protibolečinsko obsevanje kosti je učinkovito, stroškovno učinkovito in varno. Pomembno je prepoznati bolnike, ki bi imeli korist od protibolečinskega obsevanja, in jih napotiti na konzilij. S poenostavitvijo radioterapevtskih postopkov in odločitvijo za obsevanje v enem odmerku, je lahko obsevalno zdravljenje bolniku prijaznejše in dostopnejše
Posebnosti anestezije pri morbidno debelem bolniku z rakom: prikaz primera
Get PDFObesity is a chronic disease characterized by an excessive accumulation of body fat. Obese patients often have a number of comorbidities as well as anatomical and metabolic changes that increase the risk of complications in the perioperative period of treatment and significantly influence the choice of anesthetic technique as well as requiring a multidisciplinary approach. In this article, we present the case of a 60-year-old female patient with colon cancer and a body mass index (BMI) of 48.1 kg/m2. She was treated perioperatively in accordance with the Enhanced Recovery After Surgery (ERAS) protocol. Before surgery, we assessed possible risks and took them into account when managing anesthesia during surgery. After surgery, the patient was treated in the intensive care unit (ICU). In this paper, we focus on the anesthesiology aspects of perioperative management. Although obesity is undoubtedly an important risk factor for surgical treatment, recent studies report favorable effects of obesity with lower perioperative morbidity and mortality. This is the so-called obesity paradox, as excessive body mass is considered a protective factor that protects against complications of surgical treatment, which we also confirmed in our case. At the same time, we defined the critical points in the anesthesia of a morbidly obese patient and identified those areas in which anesthesiologists — taking into account the ERAS protocol — can make a significant contribution to the patient recovering as quickly as possible.Debelost je kronična bolezen, za katero je značilno čezmerno kopičenje maščevja v telesu. Debeli bolniki imajo pogosto številne pridružene bolezni ter anatomske in presnovne spremembe, ki so povezane z večjim tveganjem za zaplete v perioperativnem obdobju. Debelost tako pomembno vpliva na izbiro anestezijske tehnike in zahteva multidisciplinarni pristop. V prispevku predstavljamo primer 60-letne bolnice z rakom na debelem črevesu in indeksom telesne mase (ITM) 48,1 kg/m2. Perioperativno smo jo obravnavali v skladu s protokolom za hitro okrevanje po kirurškem posegu (angl. Enhanced Recovery After Surgery, ERAS). Pred kirurškim posegom smo ocenili morebitna tveganja in jih upoštevali pri vodenju anestezije med kirurškim posegom. Po posegu smo bolnico obravnavali v enoti intenzivne terapije (EIT). V prispevku se osredotočamo na anesteziološke vidike perioperativnega vodenja. Čeprav je debelost nedvomno pomemben dejavnik tveganja kirurškega zdravljenja, pa v novejših raziskavah poročajo tudi o ugodnih vplivih debelosti z manjšo perioperativno obolevnostjo in smrtnostjo. Gre za t. i. paradoks debelosti, saj čezmerna telesna masa velja za zaščitni dejavnik, ki varuje pred zapleti kirurškega zdravljenja, kar smo potrdili tudi v našem primeru. Hkrati smo opredelili kritične točke pri anesteziji morbidno debelega bolnika in tista področja, na katerih lahko anesteziologi – ob upoštevanju protokola ERAS – pomembno prispevamo k bolnikovemu čim hitrejšemu okrevanju
Stereotaktična radioterapija za zdravljenje refraktarne prekatne tahikardije: prikaz primerov
Get PDFThe development of novel treatment methods is crucial for managing refractory ventricular tachycardia resistant to conventional therapies. Stereotactic arrhythmia radiotherapy holds promising potential for such patients, enabling precise non-invasive ablation of arrhythmogenic substrate with minimal damage to surrounding organs. This approach could be invaluable for patients in whom the target tissue is inaccessible through catheter ablation, frequent implantable cardioverter-defibrillator shocks significantly diminish their quality of life, or for those contraindicated for such treatment options due to poor health status. The target for irradiation is precisely defined through prior imaging diagnostics, ECGs of ventricular tachycardias and invasive or non-invasive electrophysiological mapping of the heart. After radiation treatment planning, irradiation of a single high dose of 25 Gy follows, which is generally well tolerated by the patients. Previous studies have reported good treatment efficacy, with a significant reduction in ventricular tachycardia episode frequency, while causing minimal side effects. We report on the first group of four patients with high-risk refractory ventricular tachycardia treated with stereotactic arrhythmia radiotherapy at the Institute of Oncology Ljubljana. This opens new possibilities for the treatment of this vulnerable patient group within the Slovenian healthcare system and contributes to the evolving field of radiotherapeutic treatment.Stereotaktična radioterapija aritmij (STAR) predstavlja novo in obetavno možnost za bolnike z refraktarno prekatno tahikardijo, ki je odporna proti konvencionalnim metodam zdravljenja. STAR omogoča natančno neinvazivno ablacijo aritmogenega substrata ob minimalni prizadetosti sosednjih organov. Ta metoda zdravljenja je uporabna za bolnike, pri katerih je tarčno tkivo s katetrsko ablacijo nedosegljivo, pogosti šoki implantabilnega kardioverter-defibrilatorja pa močno nižajo njihovo kakovost življenja ali kadar sta ti metodi zdravljenja zaradi slabega zdravstvenega stanja kontraindicirani. Tarčo obsevanja (predel levega prekata) natančno opredelimo s predhodno slikovno diagnostiko, elektrokardiogramom, posnetki prekatne tahikardije in po potrebi invazivnim ali neinvazivnim elektrofiziološkim mapiranjem srca. Po pripravi na obsevanje na simulatorju sledi enkratno obsevanje z visokim odmerkom 25 Gy, ki je trenutno edina standardna frakcionacija. Bolniki obsevanje dobro prenašajo. Dosedanje raziskave so poročale o dobri učinkovitosti zdravljenja z bistvenim zmanjšanjem pogostosti epizod prekatne tahikardije in brez večjih neželenih učinkov. Poročamo o prvi skupini štirih bolnikov z visokorizično refraktarno prekatno tahikardijo, ki so bili zdravljeni s stereotaktično radioterapijo na Onkološkem inštitutu Ljubljana. Izvedba STAR se je izkazala kot učinkovita metoda z nizko stopnjo akutnih neželenih učinkov in predstavlja novo možnost obravnave te ranljive skupine bolnikov v slovenskem prostoru
Maligna utesnitev hrbtenjače: klinični primer s pregledom področja
Get PDFMalignant spinal cord compression is one of the most serious complications of cancer and represents an oncologic emergency. Timely diagnosis and treatment within 24 hours of symptom onset affects disease outcome and patient’s quality of life. Most of the patients that present with spinal cord compression have a known diagnosis of cancer, yet in some of them spinal cord compression is the first clinical manifestation of the disease. Most cases of spinal cord compression are the result of tumour growth from the vertebral body into the spinal canal, dislocation of bone fragments, intramedullary and leptomeningeal metastases are less frequent causes of spinal cord compression. The most common site of malignant spinal cord compression is the thoracic spine. Back pain is the first symptom in majority of patients, later sensory and/or motor deficits and loss of sphincter control can occur. Magnetic resonance imaging of the whole spine is the gold standard in the diagnostic of malignant spinal cord compression. Radiotherapy with or without surgery is the most common treatment approach. We present a case of a patient with prostate cancer with known bone metastases and spinal cord compression.Maligna utesnitev hrbtenjače predstavlja eno izmed nujnih stanj v onkologiji. Izrazit je pomen hitrega ukrepanja znotraj 24 ur, ki pripomore k izidu zdravljenja in nadaljnji kvaliteti življenja bolnika. V večini primerov ima bolnik že znano diagnozo raka, vendar se pri nekaterih maligna utesnitev hrbtenjače pojavi kot prva klinična manifestacija. Le-ta je najpogosteje posledica utesnitve hrbtenjače in hrbteničnega kanala bodisi zaradi rasti tumorja neposredno iz vretenca v svetlino kanala redkeje pa je posledica pritiska kostnih odlomkov na hrbtenjačo, intramedularnih ali leptomeningealnih zasevkov. Najpogosteje je prizadeta prsna hrbtenica. V klinični sliki je vodilni simptom navadno bolečina v predelu hrbtenice, v statusu pa je značilen izpad senzoričnih in/ali motoričnih funkcij z nivojem, ki odraža mesto lezije. Skladno z mestom okvare so lahko pridružene sfinkterske motnje. Največji pomen v diagnostiki maligne utesnitve hrbtenjače ima slikanje z magnetno resonanco. Pomemben pristop k zdravljenju predstavlja radioterapija z ali brez predhodnega kirurškega posega. V prispevku je prikazan primer 60-letnega bolnika z rakom prostate z znanimi kostnimi zasevki in maligno utesnitvijo hrbtenjače
Kazalniki kakovosti v radioterapiji
Get PDFProviders and payers alike are increasingly committing themselves to ensuring the quality of healthcare services. Moreover, international organizations condition the awarding of accreditations with the implementation of a quality control programme. Quality indicators are tools used to analyze weaknesses in the provision of healthcare services. They are used to analyze the structure, process and outcomes of healthcare systems; they also aid in the planning and implementation of improvements in healthcare services. There is a tradition of quality management in the field of radiotherapy which is evolving along with technical and methodological changes in the field. Analyzing treatment outcomes, the most important quality indicator of oncological patient care, is often complicated by the unreliability or inaccessibility of patient data; this reduces the timeliness and credibility of the results. The purpose of this article is to provide an overview of quality indicators in radiation oncology.Zagotovitev kakovosti v zdravstvu postaja pomembnejša dejavnost plačnikov in ponudnikov zdravstvenih storitev, prav tako mednarodne organizacije uspešno akreditacijo pogojujejo z izvajanjem programov nadzora kakovosti. Za analizo pomanjkljivosti v zagotavljanju storitev se uporabljajo kazalniki kakovosti, ki analizirajo strukture, procese in izide v zdravstvenem sistemu in s tem omogočijo načrtovanje in izvedbo izboljšav zdravstvenih storitev. V radioterapiji je tradicija nadzora kakovosti, ki se razvija vzporedno s tehnološkimi in metodološkimi spremembami na tem področju. Pri analizi izidov zdravljenja, ki so najbolj poveden kazalnik kakovosti onkoloških zdravstvenih storitev, se velikokrat srečujemo z nezanesljivostjo podatkov oz. zapletenim dostopom do njih, kar zmanjšuje ažurnost in verodostojnost rezultatov. Namen tega članka je pregled kazalnikov kakovosti v radioterapiji in onkologiji
Elektronske cigarete, ogrevani tobačni izdelki, nikotinske vrečke in brezdimni tobačni izdelki: kaj o teh izdelkih s tobakom ali nikotinom povedo raziskave?
Get PDFIn Slovenia, tobacco smoking remains one of the most important preventable risk factors for death and healthy years of life lost. Slovenia and numerous developed countries are experiencing a decline in smoking prevalence. In order to maintain or increase sales and profits, the industry is launched various types of tobacco or nicotine products, such as electronic cigarettes, heated tobacco products and nicotine pouches, which are also present in Slovenia. Smokeless tobacco products are also becoming increasingly popular in Slovenia. Heated tobacco products, electronic cigarettes and nicotine pouches expose the user to significant levels of harmful substances. The long-term effects of their use on health have not yet been adequately studied, as they are in use for too short a time. However, the available data indicate that they have adverse effects on health, some already in the short term, and that they are likely to lead to significant health consequences in the long term. It cannot be claimed that these products are less harmful than smoking, as there is a lack of good quality studies. The harmful effects of long-term use of smokeless tobacco products are known. All of these products are also often promoted as effective smoking cessation aids, but again there is not enough good quality research to draw conclusions about their role in smoking cessation, so they are not recommended for this purpose. All of these products contain nicotine (the exception being nicotine-free electronic cigarettes) and are addictive to the user. The use of nicotine products by youth is associated with additional important risks, such as addiction, which develops more rapidly and more strongly than in adults, and adverse effects on brain development. The use of electronic cigarettes and smokeless tobacco products among youth is also associated with increased risk of cigarette smoking in the future. Data for Slovenia show that the use of these products among youth increases with age and that the percentages of users among youth mostly exceed that of the population aged 25 and over. In recent years, the percentages of users of electronic cigarettes and smokeless tobacco products have been increasing more markedly among adolescents than adults. It is crucial to regulate these products more strictly as soon as possible to prevent and reduce their use, especially among youth.V Sloveniji je kajenje tobaka še vedno med najpomembnejšimi preprečljivimi dejavniki tveganja za smrt in na prvem mestu za izgubljena zdrava leta življenja. V Sloveniji in številnih razvitih državah beležimo zniževanje prevalence kajenja. Industrija je za ohranitev oziroma večanje prodaje in dobička dala na trg različne vrste izdelkov s tobakom ali nikotinom, kot so elektronske cigarete, ogrevani tobačni izdelki in nikotinske vrečke, ki so prisotni tudi v Sloveniji. Vse bolj priljubljeni v Sloveniji postajajo tudi brezdimni tobačni izdelki. V bibliografski podatkovni zbirki PubMed smo poiskali sistematične preglede in metaanalize o vplivih na zdravje pri uporabi teh izdelkov, poiskali poročila mednarodnih organizacij o njihovem vplivu na zdravje in okolje ter uporabili najnovejše dostopne podatke iz slovenskih nacionalnih raziskav za prikaz razširjenosti njihove uporabe v Sloveniji. Ogrevani tobačni izdelki, elektronske cigarete in nikotinske vrečke izpostavijo uporabnika znatnim ravnem zdravju škodljivih snovi. Dolgoročni učinki njihove uporabe na zdravje še niso ustrezno raziskani, saj so v uporabi še prekratek čas, dostopni podatki pa kažejo, da imajo škodljive učinke na zdravje, nekateri že kratkoročno, in da bodo verjetno privedli do pomembnih posledic za zdravje pri dolgoročni uporabi. O manjši škodljivosti teh izdelkov v primerjavi s kajenjem cigaret ni možno govoriti, saj je na voljo premalo kakovostnih raziskav, poznani pa so škodljivi učinki dolgoročne uporabe brezdimnih tobačnih izdelkov. Vsi omenjeni izdelki se pogosto promovirajo tudi kot učinkoviti pripomočki za opuščanje kajenja, a tudi na tem področju ni na voljo zadosti kakovostnih raziskav, da bi lahko sklepali zaključke o njihovi vlogi v opuščanju kajenja, zato se jih v te namene ne priporoča. Vsi omenjeni izdelki vsebujejo nikotin (izjema so elektronske cigarete brez nikotina) in uporabnika zasvojijo. Uporaba izdelkov z nikotinom med mladimi pa je povezana še z dodatnimi pomembnimi tveganji; poleg zasvojenosti, ki se razvije hitreje in močneje kot pri odraslih, so tu še škodljivi učinki na razvoj možganov, pri elektronskih cigaretah in brezdimnih tobačnih izdelkih pa tudi zvišano tveganje za kajenje cigaret v prihodnosti. Podatki za Slovenijo kažejo, da uporaba teh izdelkov med mladimi narašča s starostjo ter da med mladimi odstotki uporabnikov večinoma presegajo odstotek med populacijo, starejšo od 25 let. V zadnjih letih odstotki uporabnikov elektronskih cigaret in brezdimnih tobačnih izdelkov med mladostniki naraščajo izraziteje kot med odraslimi. Ključna je čimprejšnja strožja zakonodajna ureditev teh izdelkov, da preprečimo in zmanjšamo njihovo uporabo, predvsem med mladimi
Tehnologija Hyper Arc za izvedbo stereotaktične radiokirurgije v zdravljenju možganskih metastaz
Get PDFHyper Arc is an innovative software that was introduced at the Institute of Oncology Ljubljana in June 2020. It enables high-precision treatment of multiple lesions in the brain with a single isocenter – the number of targets that can be addressed with one isocenter seems to be unlimited. It is most useful in the local treatment of brain metastases, which are an increasingly frequent cause of morbidity and mortality in patients with malignant diseases. Based on the latest research and guidelines, stereotactic radiosurgery is considered the primary choice to improve survival and may be the best treatment choice for multiple brain metastases. Local control of each irradiated lesion and possible late toxicity are increasingly clinically important, which may affect not only survival but also neurocognitive function and quality of life.Hyper Arc je inovativna programska in strojna oprema za izvedbo stereotaktične radiokirurgije, ki je od junija 2020 dostopna na Onkološkem inštitutu Ljubljana. Omogoča visoko natančno, monoizocentrično obsevanje v teoriji neomejenega števila možganskih tarč. Najbolj uporabna je v lokalnem zdravljenju možganskih metastaz, ki so vedno pogostejši vzrok obolevnosti in umrljivosti bolnikov z malignimi boleznimi.Glede na najnovejše raziskave in smernice se stereotaktična radiokirurgija obravnava kot primarna izbira za izboljšanje preživetja in je lahko najboljša izbira zdravljenja več metastaz v možganih. Lokalna kontrola vsake obsevane lezije in morebitna pozna toksičnost sta vedno pomembnejšega kliničnega pomena, ki lahko vplivata ne le na preživetje, temveč tudi na nevrokognitivno funkcijo in kakovost življenja
Posodobljena priporočila diagnostike in zdravljenja diferenciranega raka ščitnice
Get PDFno abstractni abstrakt
Priporočila za zobozdravstveno obravnavo odraslih bolnikov z rakom glave in vratu v Sloveniji, zdravljenih z obsevanjem
Get PDFRecommendations for the dental treatment of patients with head and neck cancer (HNC) in Slovenia treated with radiation follow the recommendations and guidelines of the Royal College of Surgeons of England created in association with the British Society for Disability and Oral Health, the Recommendations for the treatment of patients with head and neck cancer in Slovenia and at the same time consider the existing capabilities of the Slovenian health care system. The recommendations aim to prevent or reduce complications in the oral cavity due to radiation therapy. They define the dental care before, during and after radiation therapy at all three levels of dental care, which ensures the timeliness and accessibility of dental care. The recommendations represent a unified opinion of all stakeholders in the field of dental treatment of HNC patients in the country.Priporočila za zobozdravstveno obravnavo bolnikov z rakom glave in vratu (RGV) v Sloveniji, zdravljenih z obsevanjem sledijo priporočilom The Royal College of Surgeons of England v sodelovanju z The British Society for Disability and Oral Health, dopolnjujejo Priporočila za obravnavo bolnikov z rakom glave in vratu v Sloveniji in hkrati upoštevajo obstoječe zmožnosti slovenskega zdravstvenega sistema. Namen priporočil je prepre-čevanje oz. zmanjšanje zapletov v ustni votlini, ki nastanejo zaradi obsevanja. Opredeljujejo način zobozdravstvene oskrbe pred, med in po zdravljenju raka na vseh treh nivojih zobozdra-vstvene oskrbe, kar zagotavlja njeno pravočasnost in dostopnost. Priporočila predstavljajo poenoteno mnenje vseh deležnikov na področju zobozdravstvene obravnave bolnikov z RGV v državi
Mobilna paliativna enota Onkološkega inštituta Ljubljana
Get PDFBackgound: Palliative care is a part of the holistic treatment of a patient with advanced cancer, which enables the patient and his or her relatives to live a quality life. In Slovenia, palliative care is provided at two levels: basic and specialized palliative care. As a specialized palliative care hospital, the Institute of Oncology Ljubljana provides care for patients with the most complex problems, an outpatient clinic for early palliative care, and a counselling service, as well as telephone support and home visits for patients at home. The mobile palliative care unit, which was implemented in September 2021, is the latest activity.
Methods: We analyzed the data of all patients involved in specialized palliative care throughout the year, from the beginning of the operation of the mobile palliative unit until the end of August 2022. We observed age, gender, place of permanent residence, diagnosis, and place of death, and compared groups of patients who were monitored in the context of specialized palliative care with or without the support of the mobile palliative team.
Results: Between September 2021 and August 2022 1,086 patients were included in all specialized palliative care activities at the Institute of Oncology Ljubljana, of which 347 patients (32%) received a total of 574 home visits (an average of 1.7 visits per patient (range 1-8)). 317 (91%) patients had their permanent residence in the Central Slovenia region, while 9% were visited outside the borders. A comparison of groups of patients referred to specialized palliative care with or without the activation of a mobile palliative unit clearly shows a higher proportion of those who died at home when support was provided by home visits (80% vs 62%) of the mobile palliative team.
Conclusion: The mobile palliative care unit represents an important element of the palliative care network and ensures more frequent dying in the home environment.Izhodišče: Del celostne obravnave bolnika z napredovalim rakom je tudi paliativna oskrba, ki bolniku in njegovim bližnjim omogoča kakovostno življenje. Paliativna oskrba se izvaja na dveh ravneh: osnovni in specializirani. Na Onkološkem inštitutu Ljubljana v okviru specializirane paliativne oskrbe izvajamo več dejavnosti: bolnišnično obravnavo bolnikov z najkompleksnejšimi težavami, ambulantno obravnavo za zgodnjo paliativno oskrbo, konziliarno (svetovalno) dejavnost in za bolnike doma telefonsko podporo ter obiske na domu. Mobilna paliativna enota je najnovejša dejavnost, ki se izvaja od septembra 2021.
Metode: Analizirali smo podatke vseh bolnikov, vključenih v specializirano paliativno oskrbo med septembrom 2021, od pričetka delovanja mobilne paliativne enote, in koncem avgusta 2022. Opazovali smo starost, spol, kraj stalnega prebivališča, diagnozo ter kraj smrti in primerjali skupino bolnikov, ki so bili obravnavani v okviru specializirane paliativne oskrbe s podporo obiskov na domu, in skupino brez nje.
Rezultati: Med opazovanim obdobjem je bilo v vse dejavnosti specializirane paliativne oskrbe Onkološkega inštituta vključenih 1086 bolnikov, od tega smo pri 347 bolnikih (32 % vseh) opravili 574 obiskov na domu (povprečno 1,7 obiska na bolnika (razpon 1–8)). 317 (91 %) bolnikov je imelo svoje stalno prebivališče v osrednjeslovenski regiji, 9 % obiskov je bilo izvedenih izven meja osrednjeslovenske regije. Primerjava skupin bolnikov, napotenih v specializirano paliativno oskrbo z vključitvijo mobilne paliativne enote ali brez nje, jasno kaže večji delež umrlih v domačem okolju, kadar podporo izvajamo tudi z obiski na domu (80 % v primerjavi z 62 %).
Zaključek: Mobilna paliativna enota predstavlja pomemben element mreže paliativne oskrbe in zagotavlja pogostejše umiranje v domačem okolju