Benefits of Early Utilization of Palliative Care Consultation in Trauma Patients

Abstract

OBJECTIVES: To determine the effects of palliative care consultation if performed within 72 hours of admission on length of stay (LOS), mortality, and invasive procedures. DESIGN: Retrospective observational study. SETTING: Single-center level 1 trauma center. PATIENTS: Trauma patients, admitted to ICU with palliative care consultation. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: The ICU LOS was decreased in the early palliative care (EPC) group compared with the late palliative care (LPC) group, by 6 days versus 12 days, respectively. Similarly, the hospital LOS was also shorter in the EPC group by 8 days versus 17 days in the LPC group. In addition, the EPC group had lower rates of tracheostomy (4% vs 14%) and percutaneous gastrostomy tubes (4% vs 15%) compared with the LPC group. There was no difference in mortality or discharge disposition between patients in the EPC versus LPC groups. It is noteworthy that the patients who received EPC were slightly older, but there were no other significant differences in demographics. CONCLUSIONS: EPC is associated with fewer procedures and a shorter amount of time spent in the hospital, with no immediate effect on mortality. These outcomes are consistent with studies that show patients’ preferences toward the end of life, which typically involve less time in the hospital and fewer invasive procedures.