Characteristics of palliative care consultation at an academic level one trauma center

Am J Surg. 2017 Oct;214(4):657-660. doi: 10.1016/j.amjsurg.2017.06.010. Epub 2017 Jun 28.

Abstract

Background: The current status of palliative care consultation for trauma patients has not been well characterized. We hypothesized that palliative care consultation currently is requested for patients too late to have any clinical significance.

Methods: A retrospective chart review was performed for traumatically injured patients' ≥18 years of age who received palliative care consultation at an academic medical center during a one-year period.

Results: The palliative care team evaluated 82 patients with a median age of 60 years. Pain and end of life were the most common reasons for consultation; interventions performed included delirium management and discussions about nutritional support. For decedents, median interval from palliative care consultation to death was 1 day. Twenty seven patients died (11 in the palliative care unit, 16 in an ICU). Nine patients were discharged to hospice.

Conclusions: Most consultations were performed for pain and end of life management in the last 24 h of life, demonstrating the opportunity to engage the palliative care service earlier in the course of hospitalization.

Keywords: Delirium; Disposition; Nutrition; Palliative; Trauma.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Female
  • Glasgow Coma Scale
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Pain Management
  • Palliative Care*
  • Referral and Consultation*
  • Retrospective Studies
  • Terminal Care
  • Trauma Centers*
  • United States / epidemiology
  • Wounds and Injuries / mortality
  • Wounds and Injuries / therapy*