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The prevalence of palliative care consultation in deceased COVID-19 patients and its association with end-of-life care
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Objectives: To describe the frequency of palliative care consultation and its association with end-of-life care for deceased patients with COVID-19.
Methods: Adults who were admitted to our institution between February 23, 2020, and April 21, 2020, and died from COVID-19 were included. The primary outcome was the frequency of palliative care consultation. Secondary analyses included the association of palliative care consultation with code status at the time of death, life-sustaining treatments, mechanical ventilation, invasive procedures, intensive care unit (ICU) admissions, and length of hospital stay.
Results: The 203 patients were 61% male with median age 76 (interquartile range [IQR] 67–84) years. Palliative care was consulted for 113 patients (56%). At baseline, they were less independent in instrumental activities of daily living (28 patients, 26.1%, vs. 47 patients, 49.0%, p < 0.01) and had more do-not-resuscitate orders (35 patients, 32.7%, vs. 11 patients, 11.5%, p < 0.01). Palliative care consultation was associated with fewer invasive procedures (0, IQR 0–2, vs. 2, IQR 0–3, p < 0.01), less mechanical ventilation (32 patients, 29.9% vs. 65 patients, 67.7%, p < 0.01), and fewer ICU admissions (33 patients, 30.8% vs. 69 patients, 71.9%, p < 0.01). Palliative care was associated with shorter ICU stays (0 days, IQR 0–4, vs. 4 days, IQR 0–12, p < 0.01), whereas hospital stays did not differ significantly (8 days, IQR 5–12.5, vs. 10 days, IQR 5–16.3, p = 0.15).
Conclusion: Palliative care was consulted for roughly half of deceased patients with COVID-19 and those patients were less likely to undergo invasive procedures or life-sustaining treatments and spent less time in the ICU at the end of life.
https://www.liebertpub.com/doi/10.1089/jpm.2021.0049
Voir la revue «JOURNAL OF PALLIATIVE MEDICINE, 25»
Autres numéros de la revue «JOURNAL OF PALLIATIVE MEDICINE»
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