The Impact of a Dedicated Palliative Care Unit on a Busy Medical Intensive Care Unit in an Academic Setting; a Retrospective Review

Campbell J, Wang L and Karlekar M

Department of Medicine, Vanderbilt University Medical Center, USA
Department of Biostatistics, Vanderbilt University Medical Center, USA
Division of General Medicine, Vanderbilt University Medical Center, USA

^*Correspondance to: Mohana Karlekar 

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Abstract:

Introduction: Palliative care aims to maximize quality of life for those patients facing serious illness. There is growing evidence to demonstrate that palliative care (PC) consultation teams have been associated with improvement in quality markers such as reduction in intensive care unit length of stay (LOS) and mortality. Palliative care units (PCUs) are geographically designated units where patients are cared for by specially trained staff. PCUs are less prevalent nationally and so there are fewer studies exist examining the impact of PCUs in institutions that already have a PC consultation team. The aim of this study was to examine the impact of establishing a PCU on a medical intensive care unit (MICU) that often runs at maximum capacity specifically focusing on MICU LOS, and mortality and indirectly capacity.
Methods: Retrospective chart review was performed on patients receiving a PC consultation in the MICU one year before and after the establishment of a PCU in an academic university hospital. The primary outcome variables include time to MICU discharge, MICU length of stay, and mortality at MICU discharge. Clinical factors were compared between two time periods using wilcoxon rank sum test or Pearson chi-square test where appropriate.
Results: MICU LOS was shorter in the group after the establishment of a PCU compared to that before establishment of PCU (median 4.2 vs. 5.1 days, p=0.015). The MICU mortality rate was 11% after the PCU and 34% before the PCU (p<0.001).
Conclusion: The addition of a PCU can significantly reduce MICU LOS and mortality, thereby adding needed capacity for patients who need intensive care.

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Cite the Article:

Campbell J, Wang L, Karlekar M. The Impact of a Dedicated Palliative Care Unit on a Busy Medical Intensive Care Unit in an Academic Setting; a Retrospective Review. Clin Oncol. 2016; 1: 1059.