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The Prevalence of Palliative Care Consultation in Deceased COVID-19 Patients and Its Association with End-of-Life Care.
Golob, Stephanie; Zilinyi, Robert; Godfrey, Sarah; DeFilippis, Ersilia M; Fried, Justin; Sayer, Gabriel; Blinderman, Craig D; Uriel, Nir; Nakagawa, Shunichi.
  • Golob S; Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Zilinyi R; Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Godfrey S; Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • DeFilippis EM; Division of Cardiology, Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Fried J; Division of Cardiology, Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Sayer G; Division of Cardiology, Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Blinderman CD; Adult Palliative Care Service, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Uriel N; Division of Cardiology, Department of Medicine, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
  • Nakagawa S; Adult Palliative Care Service, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
J Palliat Med ; 25(1): 70-74, 2022 01.
Article in English | MEDLINE | ID: covidwho-1287969
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Terminal Care / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: J Palliat Med Journal subject: Health Services Year: 2022 Document Type: Article Affiliation country: Jpm.2021.0049

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Terminal Care / COVID-19 Type of study: Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male Language: English Journal: J Palliat Med Journal subject: Health Services Year: 2022 Document Type: Article Affiliation country: Jpm.2021.0049