Palliative Care Use in Patients With Acute Myocardial Infarction and Do-Not-Resuscitate Status From a Nationwide
Ofer Kobo1, Saadiq M Moledina2, Mohamed O Mohamed2
1Department of Cardiology, Hillel Yaffe Medical Centre, Hadera, Israel; Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, UK.
Mayo Clinic Proceedings
|November 13, 2022
Summary
Palliative care was used in only one-third of hospitalized acute myocardial infarction (AMI) patients with a do-not-resuscitate (DNR) order. These patients received less invasive treatment but had higher in-hospital mortality rates.
Area of Science:
- Cardiology
- Palliative Care
- Health Services Research
Background:
- Acute myocardial infarction (AMI) is a critical condition requiring comprehensive care.
- Do-not-resuscitate (DNR) orders indicate a patient's preference to forgo life-sustaining treatments.
- Palliative care aims to improve quality of life for patients with serious illnesses.
Purpose of the Study:
- To investigate the predictors, treatments, and outcomes associated with palliative care use in hospitalized AMI patients with DNR orders.
Main Methods:
- Utilized the National (Nationwide) Inpatient Sampling database from 2015-2018.
- Analyzed 339,270 hospital admissions for AMI with DNR orders.
- Compared characteristics and outcomes of palliative care recipients versus non-recipients.
Main Results:
- Palliative care was utilized in 33.4% of eligible AMI patients.
- Palliative care recipients were younger, less often female, and more likely to have cardiac arrest.
- These patients received less invasive procedures (angiography, PCI) and had higher in-hospital mortality (52.4% vs 22.9%).
Conclusions:
- Palliative care is underutilized in AMI patients with DNR orders.
- Palliative care use is associated with less invasive interventions and increased in-hospital death.
- Further research is needed to optimize palliative care integration for this population.
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