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Palliative Care Consultation is Associated with Decreased Rates of In-Hospital Mortality Among Patients Undergoing
Claire Morton1, Hilary Hayssen1, Qingwen Kawaji2
1University of Maryland School of Medicine, Baltimore, MD.
Annals of Vascular Surgery
|May 20, 2022
Summary
Palliative care consultation for major amputation patients was associated with lower in-hospital mortality and increased hospice discharge. This study highlights the benefits of integrating palliative medicine into vascular surgery care.
Area of Science:
- Vascular Surgery
- Palliative Medicine
- Health Services Research
Background:
- Major amputation carries significant risks for morbidity and mortality.
- Palliative care can improve patient outcomes and align treatment with goals.
- Access to palliative medicine is limited for vascular surgery patients.
Purpose of the Study:
- To describe the utilization of formal palliative care consultation for patients undergoing major amputations.
- To evaluate the impact of palliative care consultation on patient outcomes.
Main Methods:
- Retrospective analysis of 292 patients undergoing major lower extremity amputation (2016-2021).
- Examined palliative care consultation during index admission as the primary outcome.
- Secondary outcomes included in-hospital mortality, code status, and discharge destination.
Main Results:
- 12% of patients received palliative care consultation.
- Consultation was associated with lower in-hospital mortality (OR=0.248, P=0.0167).
- Palliative care consult increased likelihood of discharge to hospice (OR=1.283, P<0.001).
Conclusions:
- Palliative medicine consultation is linked to reduced in-hospital mortality in major amputation patients.
- Findings support the need for prospective research on palliative care integration in vascular surgery.
- Further studies should focus on identifying patients who would benefit most from palliative care.
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