The impact of inpatient palliative care on end-of-life care among older trauma patients who die after hospital discharge

The Journal of Trauma and Acute Care Surgery
Elizabeth J LilleyZara Cooper

Abstract

Palliative care (PC) is associated with lower-intensity treatment and better outcomes at the end of life. Trauma surgeons play a critical role in end-of-life (EOL) care; however, the impact of PC on health care utilization at the end of life has yet to be characterized in older trauma patients. This retrospective cohort study using 2006 to 2011 national Medicare claims included trauma patients 65 years or older who died within 180 days after discharge. The exposure of interest was inpatient PC during the trauma admission. A non-PC control group was developed by exact matching for age, comorbidity, admission year, injury severity, length of stay, and post-discharge survival. We used logistic regression to evaluate six EOL care outcomes: discharge to hospice, rehospitalization, skilled nursing facility or long-term acute care hospital admission, death in an institutional setting, and intensive care unit admission or receipt of life-sustaining treatments during a subsequent hospitalization. Of 294,665 patients who died within 180 days after discharge, 2.1% received inpatient PC. Among 5,693 matched pairs, inpatient PC was associated with increased odds of discharge to hospice (odds ratio [OR], 3.80; 95% confidence interval [CI], 3...Continue Reading

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Citations

Oct 29, 2019·The Journal of Trauma and Acute Care Surgery·Michele FiorentinoAnne C Mosenthal
Feb 12, 2020·Journal of the American Geriatrics Society·Katherine C LeeZara Cooper
Jul 23, 2020·Geriatrics & Gerontology International·Emily LeedeCarlos Brown
Jul 11, 2019·Journal of Surgical Oncology·Anghela Z ParedesTimothy M Pawlik
Jan 13, 2021·The American Journal of Hospice & Palliative Care·Michael MorrisKatharina M Busl
Oct 20, 2020·The Journal of Trauma and Acute Care Surgery·Constance McGrawDavid Bar-Or
Apr 9, 2021·The Journal of Surgical Research·Joanna WycechIvan Puente
May 12, 2021·The Journal of Bone and Joint Surgery. American Volume·Henk Jan SchuijtMichael John Weaver
Mar 6, 2021·Palliative & Supportive Care·Vanessa P HoSiran M Koroukian
Jul 9, 2021·The American Journal of Hospice & Palliative Care·Kevin D KirklandElizabeth Acquista
Aug 18, 2021·Annals of Vascular Surgery·Mimmie KwongMatthew W Mell
Sep 2, 2021·The American Journal of Hospice & Palliative Care·Lindsay HainesKatherine Courtright
Jul 6, 2021·The Journal of Trauma and Acute Care Surgery·Alexis M ZebrowskiBrendan G Carr

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