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Palliative Care Consultation Reduces Heart Failure Transitions: A Matched Analysis
Michelle S Diop1,2, Garrett S Bowen1,2, Lan Jiang1
1Center of Innovation in Long-Term Services and Supports Providence VA Medical Center Providence RI.
Journal of the American Heart Association
|May 28, 2020
Summary
Palliative care for heart failure patients during hospitalization was linked to fewer readmissions and less need for mechanical ventilation. This approach supports quality of life without limiting treatments.
Area of Science:
- Cardiology
- Geriatrics
- Palliative Medicine
Background:
- Palliative care enhances quality of life and symptom management for heart failure (HF) patients.
- Unlike hospice, palliative care permits concurrent life-prolonging therapies.
- This study investigates palliative care's impact on HF patient outcomes post-hospitalization.
Purpose of the Study:
- To examine the association between palliative care during hospitalization for heart failure and subsequent patient transitions and procedures.
- To determine if palliative care influences readmission rates and the need for interventions like mechanical ventilation.
Main Methods:
- A cohort of 57,182 hospitalized heart failure patients from 2010-2015 was analyzed.
- 1431 patients receiving palliative care were propensity-matched to 1431 patients who did not.
- Outcomes assessed included multiple rehospitalizations, intensive care admissions, mechanical ventilation, and device implantation within six months.
Main Results:
- Palliative care was associated with significantly fewer multiple rehospitalizations (30.9% vs. 40.3%).
- Patients receiving palliative care experienced less mechanical ventilation (2.8% vs. 5.4%) and defibrillator implantation (2.1% vs. 3.6%).
- Adjusted analyses showed reduced hazards for multiple readmissions (aHR=0.73) and mechanical ventilation (aHR=0.76).
Conclusions:
- Palliative care during heart failure admissions is linked to reduced rehospitalizations and mechanical ventilation.
- Engaging patients and caregivers in palliative care may improve outcomes and reduce healthcare utilization.
- Palliative care is a valuable component of comprehensive heart failure management.
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