Palliative Care Referrals in Cardiac Disease.

摘要: OBJECTIVES: With evidence of benefits pediatric palliative care (PPC) integration, we sought to characterize subspecialty PPC referral patterns and end life (EOL) in advanced heart disease (AHD). METHODS: In this retrospective cohort study, compared inpatient ( RESULTS: Of 3409 early-epoch admissions, there were 110 deaths; the late epoch had 99 deaths 4032 admissions. early epoch, 45 patients (1.3% 17% deaths) referred for PPC, with 146 late-epoch (3.6% 58% deaths). Most (186 [89%]) occurred cardiac ICU after discontinuation life-sustaining therapy (138 [66%]). Medical therapies included ventilation (189 [90%]), inotropes (184 [88%]), cardiopulmonary resuscitation (68 [33%]), or mechanical circulatory support (67 [32%]), no temporal difference observed. involvement was associated decreased support, ventilation, inotropes, at EOL, children more likely be awake receiving enteral feeds. increased advance planning, lower hospital charges on day death 7 days before (respective differences $5058 [P = .02] $25 634 .02]). CONCLUSIONS: Pediatric AHD are high medical intensity; however, consultation experienced substantially less invasive interventions EOL. Further study is warranted explore these findings how principles can better integrated into care.