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- Title
The Prevalence of Palliative Care Consultation in Deceased COVID-19 Patients and Its Association with End-of-Life Care.
- Authors
Golob, Stephanie; Zilinyi, Robert; Godfrey, Sarah; DeFilippis, Ersilia M.; Fried, Justin; Sayer, Gabriel; Blinderman, Craig D.; Uriel, Nir; Nakagawa, Shunichi
- Abstract
Background: During the height of the coronavirus disease 2019 (COVID-19) pandemic in New York City, COVID-19 hospitalization was associated with high mortality. It is unknown how palliative care was utilized in this context. 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.
- Subjects
NEW York (State); PALLIATIVE treatment; CRITICALLY ill; PATIENTS; SECONDARY analysis; DO-not-resuscitate orders; DESCRIPTIVE statistics; GOAL (Psychology); INTENSIVE care units; COVID-19 pandemic; MEDICAL referrals
- Publication
Journal of Palliative Medicine, 2022, Vol 25, Issue 1, p70
- ISSN
1096-6218
- Publication type
Article
- DOI
10.1089/jpm.2021.0049