Palliative Care Consults Among Critically Ill Patients: Does Timing Matter?

Area of Science:

• Critical Care Medicine
• Palliative Care
• Health Services Research

Background:

• Palliative care is crucial for critically ill patients.
• Identifying patients who benefit most from in-ICU palliative care consults remains unclear.
• In-hospital mortality was used as a proxy for unmet palliative care needs.

Purpose of the Study:

• To compare sociodemographic and clinical characteristics of patients receiving in-ICU versus post-ICU palliative care consults.
• To evaluate the impact of consult timing on outcomes.

Main Methods:

• Retrospective cohort study of patients in a palliative care registry with ICU length of stay (LOS) ≥ 72 hours.
• Comparison of patients receiving in-ICU versus post-ICU palliative care consults.
• Utilized electronic health record and administrative data.

Main Results:

• No sociodemographic or clinical differences were found between in-ICU and post-ICU consult groups.
• Patients receiving in-ICU consults had longer median ICU LOS and more days between consult and discharge.
• No significant difference in in-hospital mortality based on consult timing.

Conclusions:

• Sociodemographic and clinical factors do not reliably predict the need for in-ICU palliative care consults.
• All studied patients faced high in-hospital mortality, irrespective of consult timing.
• Improved delivery models are needed to ensure timely in-ICU palliative care for eligible patients.