Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/16300
Title: Clinical significance of palliative care assessment in patients referred for urgent intensive care unit admission: a cohort study
Austin Authors: Ramos, Joao Gabriel Rosa;Teles Correa, Mario Diego;de Carvalho, Ricardo Tavares;Jones, Daryl A ;Forte, Daniel Neves
Affiliation: Medical Sciences PhD Program, University of Sao Paulo Medical School, Sao Paulo, Brazil
Intensive Care Unit, Hospital Sao Rafael, Salvador, Brazil
UNIME Medical School, Lauro de Freitas, Brazil
Intensive Care Unit, Hospital Sao Camilo, iMED group, Sao Paulo, Brazil
Palliative Care Team, Hospital das Clinicas, University of São Paulo Medical School, Sao Paulo, Brazil
Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
University of Melbourne, Melbourne, Victoria, Australia
Austin Health, Heidelberg, Victoria, Australia
Intensive Care Unit, Emergency Medicine Discipline, Hospital das Clinicas, University of Sao Paulo Medical School, Sao Paulo, Brazil
Palliative Care Team, Hospital Sirio-Libanes, Sao Paulo, Brazil
Issue Date: Feb-2017
Date: 2016-08-21
Publication information: Journal of Critical Care 2017; 37: 24-29
Abstract: PURPOSE: To evaluate clinical characteristics of patients with palliative care (PC) and urgent intensive care unit (ICU) referrals in the same hospital admission. METHODS: All urgent ICU referrals at an academic, tertiary hospital, and the co-occurrence and timing of PC assessment were retrieved from a prospectively collected database. RESULTS: From May 2014 to May 2015, 2476 patients were analyzed and 179 (7%) had co-occurrence of PC assessment and urgent ICU referral in the same hospital admission. Hospital mortality was higher (odds ratio, 8.3; 95% confidence interval, 5.4-12.7) and ICU admission was lower (odds ratio, 0.54; 95% confidence interval, 0.40-0.74) in patients with PC assessment, compared with patients without concurrent PC and ICU referrals. Variables associated with PC assessment were older age, diagnosis of cancer, depressed level of consciousness, nonsurgical admission, lower performance status, physician's subjective prognosis of poor outcome, and length of hospitalization before ICU referral. CONCLUSION: In this cohort of patients with urgent ICU referral, clinical characteristics at the moment of ICU referral were associated with co-occurrence of PC assessment in the same hospital admission. These characteristics might guide the development of instruments to enhance early referral of high-risk patients to PC services.
URI: https://ahro.austin.org.au/austinjspui/handle/1/16300
DOI: 10.1016/j.jcrc.2016.08.018
Journal: Journal of Critical Care
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/27610588
Type: Journal Article
Subjects: Critically ill
End-of-life
Intensive care unit
Palliative care
Prognosis
Appears in Collections:Journal articles

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