Palliative Care Integration into Cardiac Transplant Recipient Care: A Retrospective Case Series (S796)

Abstract

Evaluate the impact that the palliative care team could have on the care of these patients. Research Objectives. To describe clinical and healthcare utilization outcomes for patients who underwent hypothermia protocol following cardiac arrest and did or did not receive palliative care consultation. Methods. We identified patients admitted to a critical care unit between 2006 and 2012 who had undergone hypothermia protocol in the setting of a cardiac arrest. Results. Reviewed the charts of 62 patients who underwent hypothermia protocol following cardiac arrest, of which 35 (56%) received a palliative care consultation. Twenty-one patients (34%) survived, of which only eight (13%) had a good neurological outcome. Twenty-six (74%) of the patients seen by palliative care died (22 in the hospital, 13 after palliative extubation, four in hospice). Fifteen (56%) of those patients without a palliative consultation died in the hospital, three after palliative extubation; none died in hospice. The mean hospital length of stay was 16.71 days for patients seen by palliative care and 17.1 days for patients not seen (p¼ 0.90). Mean ICU length of stay for patients seen by palliative care was 11.34 days compared with 12.59 days for patients not seen (p 0.55). Among patients who died in the hospital, the mean length of stay was 13.40 days for patients seen by palliative care compared with 8.87 days for those not seen (p 0.06). Mean ICU length of stay among those that died in the hospital was 10.72 days for those seen by palliative care compared with 8.73 for those not seen(p 0.35). Conclusion. Palliative care consultation for patients with hypothermia protocol results in increased rates of deaths on hospice. Palliative care consultation may be associated with a lower mean ICU and hospital length of stay, however, the study was underpowered to detect a difference.