Comparison of Early Versus Late Palliative Care Consultation in End-of-Life Care for the Hospitalized Frail Elderly Patients.
To examine the effects of early palliative care (PC; EPC; ≤3 days after admission) consultation versus late PC (>3 days) on number of days from day of consult to discharge (DCDAYS), a retrospective review of PC data (2009-2012) included 531 patients with age ≥65 and Palliative Performance Scale ≤50. Early PC was independently associated with lower DCDAYS (P = .019). Persons admitted to hospice (P = .010) as well as those discharged to home (P = .003) and subacute rehabilitation (SAR; P = .015) were more likely to have an EPC compared to those who died. Admitting to hospice was associated with lower DCDAYS than discharging to long-term acute care (P < .001) or SAR (P < .001). Early PC resulted in lower DCDAYS, fewer inpatient deaths, and higher hospice admissions. Hospice resulted in fewer DCDAYS.
Gerontology Institute, Georgia State University, Atlanta, GA, USA Department of Internal Medicine, Division of Geriatric and Palliative Care, University of Texas Medical School, Houston, TX, USA careyesortiz@hotmail.com.
Carlos A
CA
Reyes-Ortiz
Geriatric & Internal Medicine, Oakwood Hospital & Medical Center, Wayne State University, Dearborn, MI, USA.
Christopher
C
Williams
Director of Oakwood Healthcare System Palliative Care Service, Oakwood Hospital & Medical Center, Dearborn, MI, USA.
Christine
C
Westphal
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006304:Health Status; D017051:Hospice Care / Q000458:organization & administration; D006738:Hospices / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D010166:Palliative Care / Q000458:organization & administration*; D000070659:Patient Comfort; D010351:Patient Discharge / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013727:Terminal Care / Q000458:organization & administration*; D013997:Time Factors
consultation; discharge destination; frail elderly patients; hospice; length of stay; palliative care