[Palliative care consultation in the ICU : Descriptive analysis of internal medicine intensive care using a mixed model over 12 months].
We retrospectively analyzed the data of 56 of 669 critically ill patients admitted to an internal medicine intensive care unit (ICU) with palliative care provided by a palliative care team over the period of 12 months. For delivering palliative care, we used a mixed model-consisting of both integrative and consultative elements. SAPS III severity score in patients with palliative care was 63 ± 15 compared to 50 ± 15 in all critically ill patients. Hospital mortality was 62.5 vs. 16%. After 3 months, 19.6% of patients with palliative care provided by the palliative care team were still alive. In 15 patients curative therapies were discontinued, while there was no further escalation of the therapy in 30 patients. In 47 patients, special help to the relatives was offered. In 13 cases, there was a disagreement between relatives and the ICU team; in 5 cases a family conference was implemented. Two patients wanted extensive intensive care therapy, despite unfavorable prognosis; one patient wished to die. One patient had an advanced directive.
Abteilung für Innere Medizin und Intensivmedizin, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich. kurt.lenz@meduniwien.ac.at.
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K
Lenz
Palliative Care, Konventhospital Barmherzige Brüder Linz, Linz, Österreich.
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B
Hofmann-Bichler
Palliative Care, Konventhospital Barmherzige Brüder Linz, Linz, Österreich.
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J
Pihringer
Abteilung für Innere Medizin und Intensivmedizin, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich.
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F
Firlinger
Palliative Care, Konventhospital Barmherzige Brüder Linz, Linz, Österreich.
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A
Pickl
Abteilung für Innere Medizin und Intensivmedizin, Konventhospital Barmherzige Brüder Linz, Seilerstätte 2, 4020, Linz, Österreich.
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M
Clodi
D000328:Adult; D016223:Advance Directives; D000368:Aged; D003142:Communication; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D003657:Decision Making; D019033:Delivery of Health Care, Integrated; D005260:Female; D005858:Germany; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011368:Professional-Family Relations; D012017:Referral and Consultation; D012189:Retrospective Studies; D000072878:Simplified Acute Physiology Score; D028761:Withholding Treatment
Communication; ICU decision making; Intensive care unit; Palliative care