Early palliative intervention in septic patients reduces healthcare utilization
| Autor: | Evan Shapiro, Rita A. Manfredi, Murwarit Rahimi, Ali Pourmand, Pouya Gharehdaghi, Florence Yan, Jesus Trevino |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Palliative care Psychological intervention Patient Care Planning Sepsis Intervention (counseling) medicine Humans Mid-Atlantic Region Referral and Consultation Aged Retrospective Studies Aged 80 and over Retrospective review business.industry Septic shock Palliative Care Health Care Costs General Medicine Emergency department Length of Stay medicine.disease Healthcare utilization Emergency medicine Linear Models Emergency Medicine Female Emergency Service Hospital business Facilities and Services Utilization |
| Zdroj: | The American Journal of Emergency Medicine. 50:773-777 |
| ISSN: | 0735-6757 |
| DOI: | 10.1016/j.ajem.2021.09.075 |
| Popis: | While the role of palliative care in the emergency department is recognized, barriers against the effective integration of palliative interventions and emergency care remain. We examined the association between goals-of-care and palliative care consultations and healthcare utilization outcomes in older adult patients who presented to the emergency department (ED) with sepsis.We performed a retrospective review of 197 patients aged 65 years and older who presented to the ED with sepsis or septic shock. Healthcare utilization outcomes were compared between patients divided into 3 groups: no palliative care consultation, palliative care consultation within 4 days of admission (i.e., early consultation), and palliative care consultation after 4 days of admission (i.e., late consultation).51% of patients did not receive any palliative consultation, 39% of patients underwent an early palliative care consultation (within 4 days), and 10% of patients underwent a late palliative care consultation (after 4 days). Patients who received late palliative care consultation had a significantly increased number of procedures, total length of stay, ICU length of stay, and cost (p .01, p .001, p .05, p .001; respectively). Regarding early palliative care consultation, there were no statistically significant associations between this intervention and our outcomes of interest; however, we noted a trend towards decreased total length of stay and decreased healthcare cost.In patients aged 65 years and older who presented to the ED with sepsis, early palliative consultations were associated with reduced healthcare utilization as compared to late palliative consultations. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect