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Outcomes of Heart Failure Patients on Palliative Inotrope Therapy in the Hospice Setting: A Single Center
Umer A Esbhani1, Syed Hasan Raza Abidi1, Candice Tavares1
1Department of Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
Abstract:
Background: Chronic intravenous inotropic support (CIIS) is recommended as palliative therapy for end-stage heart failure (HF) but is underutilized in hospice settings. Objectives: This study evaluates outcomes for patients on CIIS receiving hospice care. Design: Retrospective cohort study using electronic health records of patients on CIIS admitted to hospice. Setting/Subjects: Twenty-one patients admitted to a mid-Atlantic hospice between 2018 and 2022. Measurements: Data collected included demographics, inotropic therapy details, hospice length of stay (LOS), hospitalizations, and medication usage. Results: The mean age was 72.9 years; 67% were on milrinone. Patients had a mean hospice LOS of 49.6 days, with 66% experiencing no hospitalizations. Only 24% of patients required high-dose opioids. 24% of patients were discharged alive from hospice, and 52% died at home. Conclusion: Caring for patients on CIIS in hospice appears feasible and may portend some benefits to patients. Further research is warranted to confirm these findings in a prospective observational cohort.
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