000			03190nam a22004097a 4500
008			210726s20202020 xxu||||| |||| 00| 0 eng d
024			_a10.1089/pmr.2020.0051 [doi]
024			_a10.1089/pmr.2020.0051 [pii]
024			_aPMC8241345 [pmc]
040			_aOvid MEDLINE(R)
099			_a34223471
245			_aPalliative Care Consultation and Effect on Length of Stay in a Tertiary-Level Neurological Intensive Care Unit.
251			_aPalliative Medicine Reports. 1(1):161-165, 2020.
252			_aPalliat. med. rep.. 1(1):161-165, 2020.
253			_aPalliative medicine reports
260			_c2020
260			_fFY2021
265			_sepublish
266			_d2021-07-26
520			_aBackground: Patients admitted to an acute care setting with a devastating brain injury are at high risk for morbidity and mortality. These patients and their families can benefit from the psychosocial and decision-making support of a palliative care consultation. Objective: We aim to investigate the characteristics and impact of palliative care consultation for patients under the management of neurosurgical and critical care services with a devastating brain injury in a neurological intensive care unit (ICU) at a large tertiary-care hospital. Design: Data were collected by retrospective review of the electronic medical record and metrics collected by the palliative care service. Data were analyzed using descriptive statistics. Linear regression analysis was performed to assess effect of timing of palliative care consultation. Results: Fifty-five patients admitted to the neurological ICU under the management of the neurosurgical service received a palliative care consultation for the following: hemorrhagic stroke (49%), metastatic cancer (22%), and traumatic brain injury (18%). Of these, 73% had at least one neurosurgical intervention. Palliative care was most frequently consulted for assistance in defining a patient's goals of care (88%). When compared with late consultation, early palliative care consultation was significantly associated with shorter mean length of stay (LOS) and positively correlated in linear regression analysis without an effect on mortality. Conclusions: When compared with a late consultation, early palliative care consultation corresponded to shorter LOS without increasing mortality. One reason for this effect may be that palliative care can help to clarify and document goals of care earlier and more concretely. Copyright (c) Michael Pottash et al., 2020 Published by Mary Ann Liebert, Inc.
546			_aEnglish
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Washington Hospital Center
656			_aMedicine/Palliative Care
656			_aNeurosurgery
656			_aNursing
656			_aSurgery/Surgical Critical Care
657			_aJournal Article
700			_aAulisi, Edward
700			_aChang, Jason J
700			_aGroninger, Hunter
700			_aMcCamey, Danielle
700			_aPottash, Michael
790			_aAulisi EF, Chang JJ, Groninger H, McCamey D, Pottash M
856			_uhttps://dx.doi.org/10.1089/pmr.2020.0051 _zhttps://dx.doi.org/10.1089/pmr.2020.0051
942			_cART _dArticle
999			_c6713 _d6713