title: The impact of a palliative care unit on mortality rate and length of stay for medical intensive care unit patients.
abstract: OBJECTIVE
  This study evaluates the impact of a 10-bed inpatient palliative care unit (PCU) on medical intensive care unit (MICU) mortality and length of stay (LOS) for terminally ill patients following the opening of an inpatient PCU. We hypothesized that MICU mortality and LOS would be reduced through the creation of a more appropriate location of care for critically ill MICU patients who were dying.
  
  
  METHODS
  We performed a retrospective electronic database review of all MICU discharges from January 1, 2006 through December 31, 2009 (5,035 cases). Data collected included MICU mortality, MICU LOS, and mean age. The PCU opened on January 1, 2008. We compared location of death for MICU patients during the 2-year period before and the 2-year period after the opening of the PCU.
  
  
  RESULTS
  Our data showed that the mean MICU mortality and MICU LOS both significantly decreased following the opening of the PCU, from 21 to 15.8% (p = 0.003), and from 4.6 to 4.0 days (p = 0.014), respectively.
  
  
  CONCLUSIONS
  The creation of an inpatient PCU resulted in a statistically significant reduction in both MICU mortality rate and MICU LOS, as terminally ill patients were transitioned out of the MICU to the PCU for end-of-life care. Our data support the hypothesis that a dedicated inpatient PCU, capable of providing care to patients requiring mechanical ventilation or vasoactive agents, can protect terminally ill patients from an ICU death, while providing more appropriate care to dying patients and their loved ones.
authors: North Shore-LIJ Health System, Great Neck, New York, USA.
authors: Glen
authors: G
authors: Digwood
authors: Dana
authors: D
authors: Lustbader
authors: Renee
authors: R
authors: Pekmezaris
authors: Martin L
authors: ML
authors: Lesser
authors: Rajni
authors: R
authors: Walia
authors: Michael
authors: M
authors: Frankenthaler
authors: Erfan
authors: E
authors: Hussain
mesh_terms: D000368:Aged; D016638:Critical Illness; D017052:Hospital Mortality / Q000639:trends*; D006757:Hospital Units / Q000639:trends; D006801:Humans; D007297:Inpatients; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D009519:New York City; D010166:Palliative Care / Q000706:statistics & numerical data* / Q000639:trends; D010360:Patient Transfer; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013727:Terminal Care / Q000706:statistics & numerical data