Palliative Care Penetration Among Hospitalizations with Acute Pulmonary Embolism: A Nationwide Analysis.

Autor: Elkaryoni A; Loyola Stritch School of Medicine, Maywood, IL, USA., Darki A; Loyola Stritch School of Medicine, Maywood, IL, USA., Bunte M; Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas, MO, USA., Mamas MA; Keele Cardiovascular Research Group, Keele University, UK., Weinberg I; Massachusetts General Hospital, Boston, MA, USA., Elgendy IY; Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar.
Jazyk: angličtina
Zdroj: Journal of palliative care [J Palliat Care] 2024 Apr; Vol. 39 (2), pp. 129-137. Date of Electronic Publication: 2022 Feb 09.
DOI: 10.1177/08258597221078389
Abstrakt: Background: Integration of palliative care in the management of critical illnesses has been linked with a better quality of life for patients and their families. Yet, there is a paucity of data regarding the role of palliative care for acute pulmonary embolism (PE) hospitalizations which is a leading cause of cardiovascular death in the United States. Methods: Using the Nationwide Inpatient Sample years 2005-2015, acute PE hospitalizations were identified by using ICD-9-codes. The primary outcome was the trends of palliative care penetration during acute PE hospitalizations and the main secondary outcome was the factors associated with palliative care utilization. Results: Among 505,485 acute PE hospitalizations, 15,522 (3.1%) had a palliative care encounter. Hospitalizations with high-risk PE versus non-high-risk PE showed a higher utilization for palliative care (7.6% vs. 2.7%, P < 0.001). The annual trends of palliative care penetration among hospitalizations with PE showed a rising pattern (0.6% in 2005 vs. 5.6% in 2015, P trend <0.001). A similar trend was observed among those with high-risk PE (0.8% in 2005 vs. 12.8% in 2015, P trend <0.001). The trends of palliative care utilization among cancer and non-cancer admissions increased over time (1.3%in 2005 to 15.5% in 2015 vs. 0.5% in 2005 to 3.9% in 2015, both P- trends <0.001). Some racial and regional disparities were identified among the predictors of palliative care utilization. Conclusions: Palliative care penetration among acute PE hospitalizations remains suboptimal even among high-risk PE, and cancer hospitalizations, but has been increasing in recent years. Future studies are needed to investigate the barriers for palliative care utilization and narrowing this gap among admissions with acute PE.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze: MEDLINE
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