Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial
Objectives:
To assess the impact of early triggered palliative care consultation on the outcomes of high-risk ICU patients.
Design:
Single-center cluster randomized crossover trial.
Setting:
Two medical ICUs at Barnes Jewish Hospital.
Patients:
Patients (n = 199) admitted to the medical ICUs from August 2017 to May 2018 with a positive palliative care screen indicating high risk for morbidity or mortality.
Interventions:
The medical ICUs were randomized to intervention or usual care followed by washout and crossover, with independent assignment of patients to each ICU at admission. Intervention arm patients received a palliative care consultation from an interprofessional team led by board-certified palliative care providers within 48 hours of ICU admission.
Measurements and Main Results:
Ninety-seven patients (48.7%) were assigned to the intervention and 102 (51.3%) to usual care. Transition to do-not-resuscitate/do-not-intubate occurred earlier and significantly more often in the intervention group than the control group (50.5% vs 23.4%; p
Source: Critical Care Medicine - Category: Emergency Medicine Tags: Clinical Investigations Source Type: research