[Palliative care consultation in the ICU : Descriptive analysis of internal medicine intensive care using a mixed
K Lenz1, B Hofmann-Bichler2, J Pihringer2
1Abteilung für Innere Medizin und Intensivmedizin, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich. kurt.lenz@meduniwien.ac.at.
Abstract:
We retrospectively analyzed the data of 56 of 669 critically ill patients admitted to an internal medicine intensive care unit (ICU) with palliative care provided by a palliative care team over the period of 12 months. For delivering palliative care, we used a mixed model-consisting of both integrative and consultative elements. SAPS III severity score in patients with palliative care was 63 ± 15 compared to 50 ± 15 in all critically ill patients. Hospital mortality was 62.5 vs. 16%. After 3 months, 19.6% of patients with palliative care provided by the palliative care team were still alive. In 15 patients curative therapies were discontinued, while there was no further escalation of the therapy in 30 patients. In 47 patients, special help to the relatives was offered. In 13 cases, there was a disagreement between relatives and the ICU team; in 5 cases a family conference was implemented. Two patients wanted extensive intensive care therapy, despite unfavorable prognosis; one patient wished to die. One patient had an advanced directive.
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