Study Examines Palliative Care in Cardiac Intensive Care Units

Patients who had end-of-life discussions had higher rate of redirected goals of care toward comfort care

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THURSDAY, March 5, 2015 (HealthDay News) -- Increased palliative care education and training among clinicians who are involved in cardiac critical care could benefit care, according to a study published in the March 1 issue of The American Journal of Cardiology.

Tara Naib, M.D., M.P.H., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues examined the role of palliative care in cardiac intensive care units (CICUs). Data were included for 1,368 patients admitted from Jan. 1 through Dec. 31, 2012.

The researchers identified 117 CICU patient deaths. End-of-life discussions were performed in 72.6 percent of those who died during that hospital admission; in more than half of these cases, the primary CICU team led these discussions and helped with decision-making. Compared with patients for whom no goals of care (GOC) discussions were held, the patients who had GOC discussions had a higher rate of redirected GOC toward comfort care or no escalation of care (38.8 versus 3.1 percent; P < 0.001) and withdrawal of life-sustaining treatments (23.5 versus 6.3 percent; P = 0.02). Between the groups, there was no difference noted in CICU length of stay or days to mortality from the time of CICU admission.

"Our study demonstrates the effect of palliative care and end-of-life decision-making in the CICU," the authors write. "As such, we advocate for increased palliative care education and training among clinicians who are involved in cardiac critical care."

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