Palliative Care Consultation Is Underutilized in Critically Ill General Surgery Patients.

Autor:	Evans BA; Duke University School of Medicine, Durham, NC, USA., Turner MC; Department of Surgery, Duke University, Durham, NC, USA., Gloria JN; Duke University School of Medicine, Durham, NC, USA., Pickett LC; Department of Surgery, Duke University, Durham, NC, USA.; Duke University Hospital, Durham, NC, USA., Galanos AN; Division of Palliative Care, Duke Department of Medicine, Duke University, Durham, NC, USA.
Jazyk:	angličtina
Zdroj:	The American journal of hospice & palliative care [Am J Hosp Palliat Care] 2020 Feb; Vol. 37 (2), pp. 149-153. Date of Electronic Publication: 2019 Jul 17.
DOI:	10.1177/1049909119864025
Abstrakt:	Background: American College of Surgeons recommends palliative care and surgeons collaborate on the care of patients with poor prognoses. These collaborations are done to discuss symptom management and goals of care. However, contemporary practice patterns of palliative care consultation for surgical patients are poorly defined. We aim to describe the use of palliative care consultation for patients admitted to our institution's surgical services who died during their index hospital admission. Methods: The Duke Enterprise Data Unified Content Explorer 2014 to 2016 was queried for patients admitted to general surgery services who died during their admission. Secondary measures included length of stay, time spent in consultation, days from consultation to death, and execution of a care plan. Results: Of the 105 patients identified, 6 died on the day of admission, and 39 (37%) received palliative care consultation. Our data showed that patients who received consultation were generally older, white, and insured. Median number of days between palliative consult and death was 3 days (interquartile range: 1-8). Goals-of-care conversations were the indication for consultation in 62.5% of patients. The proposed plan by the consultants was congruent with the primary team in 66.7% of cases. Conclusions: Palliative care consultations were underutilized in surgical patients who died while admitted to the general surgical service at our institution. When palliative care is consulted, the plan of the primary surgical team and the palliative team align. Identification of barriers to consultation and promotion of the benefits of palliative care among surgical teams is warranted.
Databáze:	MEDLINE
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