Detección de necesidades paliativas en pacientes ingresados en un hospital oncológico y no oncológico con la herramienta NECPAL 4.0.

Abstract

Introduction: Early identification of patients with palliative care needs is a key component in the management of individuals with chronic diseases. The NECPAL 4.0 tool has proven useful for the timely identification of patients who may benefit from a comprehensive palliative care approach in both oncological and non-oncological conditions. Objective: To determine palliative care needs using the NECPAL 4.0 tool among patients admitted to an oncology hospital and a non-oncology hospital between December 2025 and January 2026. Methods: An observational, descriptive, prospective, cross-sectional study was conducted involving 160 patients from SOLCA Guayaquil Hospital and Teodoro Maldonado Carbo Specialty Hospital. Data were collected using the NECPAL 4.0 tool. Descriptive analysis included frequencies, percentages, means, and standard deviations. Associations were assessed using the chi-square test, with statistical significance established at p < 0.05. Results: NECPAL positivity was 93.8% in the oncology hospital and 85.0% in the non-oncology hospital, with no statistically significant difference (p = 0.073). Oncology patients showed a higher proportion of advanced NECPAL stages (II–III) (90.0% vs. 58.8%; p = 0.001), greater access to specialized palliative care services (100% vs. 1.3%; p = 0.001), and care provided by professionals specialized in palliative care (100% vs. 3.8%; p = 0.001). Conclusions: The NECPAL 4.0 tool identified a high prevalence of patients with palliative care needs in both hospitals, with significant differences in clinical complexity and access to specialized palliative care, favoring the oncology hospital. These findings support the usefulness of NECPAL as an early identification tool and highlight the need for earlier integration of palliative care in non-oncology hospitals.