Characteristics and Outcomes of In-Hospital Palliative Care Consultation among Patients with Renal Disease Versus Other Serious Illnesses
Copyright © 2017 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Despite significant morbidity and mortality associated with ESRD, these patients receive palliative care services much less often than patients with other serious illnesses, perhaps because they are perceived as having less need for such services. We compared characteristics and outcomes of hospitalized patients in the United States who had a palliative care consultation for renal disease versus other serious illnesses.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this observational study, we used data collected by the Palliative Care Quality Network, a national palliative care quality improvement collaborative. The 23-item Palliative Care Quality Network core dataset includes demographics, processes of care, and clinical outcomes of all hospitalized patients who received a palliative care consultation between December of 2012 and March of 2016.
RESULTS: The cohort included 33,183 patients, of whom 1057 (3.2%) had renal disease as the primary reason for palliative care consultation. Mean age was 71.9 (SD=16.8) or 72.8 (SD=15.2) years old for those with renal disease or other illnesses, respectively. At the time of consultation, patients with renal disease or other illnesses had similarly low mean Palliative Performance Scale scores (36.0% versus 34.9%, respectively; P=0.08) and reported similar moderate to severe anxiety (14.9% versus 15.3%, respectively; P=0.90) and nausea (5.9% versus 5.9%, respectively; P>0.99). Symptoms improved similarly after consultation regardless of diagnosis (P≥0.50), except anxiety, which improved more often among those with renal disease (92.0% versus 66.0%, respectively; P=0.002). Although change in code status was similar among patients with renal disease versus other illnesses, from over 60% full code initially to 30% full code after palliative care consultation, fewer patients with renal disease were referred to hospice than those with other illnesses (30.7% versus 37.6%, respectively; P<0.001).
CONCLUSIONS: Hospitalized patients with renal disease referred for palliative care consultation had similar palliative care needs, improved symptom management, and clarification of goals of care as those with other serious illnesses.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 12(2017), 7 vom: 07. Juli, Seite 1085-1089 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Grubbs, Vanessa [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 24.04.2018 Date Revised 13.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2215/CJN.12231116 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM273332082 |
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| 100 | 1 | |a Grubbs, Vanessa |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Characteristics and Outcomes of In-Hospital Palliative Care Consultation among Patients with Renal Disease Versus Other Serious Illnesses |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Revised 13.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Despite significant morbidity and mortality associated with ESRD, these patients receive palliative care services much less often than patients with other serious illnesses, perhaps because they are perceived as having less need for such services. We compared characteristics and outcomes of hospitalized patients in the United States who had a palliative care consultation for renal disease versus other serious illnesses | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this observational study, we used data collected by the Palliative Care Quality Network, a national palliative care quality improvement collaborative. The 23-item Palliative Care Quality Network core dataset includes demographics, processes of care, and clinical outcomes of all hospitalized patients who received a palliative care consultation between December of 2012 and March of 2016 | ||
| 520 | |a RESULTS: The cohort included 33,183 patients, of whom 1057 (3.2%) had renal disease as the primary reason for palliative care consultation. Mean age was 71.9 (SD=16.8) or 72.8 (SD=15.2) years old for those with renal disease or other illnesses, respectively. At the time of consultation, patients with renal disease or other illnesses had similarly low mean Palliative Performance Scale scores (36.0% versus 34.9%, respectively; P=0.08) and reported similar moderate to severe anxiety (14.9% versus 15.3%, respectively; P=0.90) and nausea (5.9% versus 5.9%, respectively; P>0.99). Symptoms improved similarly after consultation regardless of diagnosis (P≥0.50), except anxiety, which improved more often among those with renal disease (92.0% versus 66.0%, respectively; P=0.002). Although change in code status was similar among patients with renal disease versus other illnesses, from over 60% full code initially to 30% full code after palliative care consultation, fewer patients with renal disease were referred to hospice than those with other illnesses (30.7% versus 37.6%, respectively; P<0.001) | ||
| 520 | |a CONCLUSIONS: Hospitalized patients with renal disease referred for palliative care consultation had similar palliative care needs, improved symptom management, and clarification of goals of care as those with other serious illnesses | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Adolescent | |
| 650 | 4 | |a Anxiety | |
| 650 | 4 | |a Demography | |
| 650 | 4 | |a Hospice Care | |
| 650 | 4 | |a Hospices | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Kidney Diseases | |
| 650 | 4 | |a Kidney Failure, Chronic | |
| 650 | 4 | |a Nausea | |
| 650 | 4 | |a Palliative Care | |
| 650 | 4 | |a Patient Care Planning | |
| 650 | 4 | |a Quality Improvement | |
| 650 | 4 | |a Quality of Health Care | |
| 650 | 4 | |a Referral and Consultation | |
| 650 | 4 | |a Retrospective Studies | |
| 650 | 4 | |a United States | |
| 650 | 4 | |a advance care planning | |
| 650 | 4 | |a end-stage renal disease | |
| 650 | 4 | |a palliative care | |
| 700 | 1 | |a O'Riordan, David |e verfasserin |4 aut | |
| 700 | 1 | |a Pantilat, Steve |e verfasserin |4 aut | |
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