Palliative care consultation in the ICU : Descriptive analysis of internal medicine intensive care using amixed model over 12months

Abstract

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 apalliative care team over the period of 12months. For delivering palliative care, we used amixed model-consisting of both integrative and consultative elements. SAPSIII 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 3months, 19.6% of patients with palliative care provided by the palliative care team were still alive. In 15patients curative therapies were discontinued, while there was no further escalation of the therapy in 30patients. In 47patients, special help to the relatives was offered. In 13cases, there was adisagreement between relatives and the ICU team; in 5cases afamily conference was implemented. Two patients wanted extensive intensive care therapy, despite unfavorable prognosis; one patient wished to die. One patient had an advanced directive.