The Effect of an Inpatient Palliative Care Service On the Incidence and Survival Outcomes of Urgent Resuscitation Attempts for Hospitalized Patients (767)

Abstract

1.Compare the incidence of urgent resuscitation attempts before and after the implementation of an inpatient palliative care service.2.Identify initial survival and disposition outcomes for patients receiving urgent resuscitation attempts before and after the implementation of an inpatient palliative care service.3.Analyze the incidence and outcomes of urgent resuscitation attempts for patients over sixty-five years of age and eighty years of age. According to several studies, the incidence and survival rate of resuscitation attempts in hospitals have remained relatively unchanged for decades. The effect of an inpatient palliative care service on these outcomes is unknown. Compare the incidence, immediate survival, and disposition outcomes for patients receiving urgent resuscitation attempts in a 555-bed urban community hospital before and after the implementation of an inpatient palliative care service in January, 2010. From hospital administrative records, we identified all resuscitation attempts in adult patients that included information regarding survival and disposition for one year prior to (2009) and one year after (2010) implementation of palliative care (n = 596). Immediate survival and disposition outcomes were analyzed for all patients and delineated for sub-groups greater than 65 years and 80 years of age. The incidence of resuscitation events decreased by 22.6% in the year following implementation of palliative care (pre = 336; post = 260) with decreases of 26.7% for ages ≥ 65 and 24.2% for ages ≥ 80. In the year following implementation of palliative care, immediate resuscitation survival increased by 1.2% for ages ≥ 65 and 6.3% for ages ≥ 80. Resuscitated patients were more likely to be discharged from the hospital alive (2.2% increase for all patients; 3.8% for ages ≥ 65; 9.2% for ages ≥ 80), following implementation of palliative care. Other than palliative care, we were unable to identify other changes in hospital policies or procedures during the study period that might have had an effect on these findings. The implementation of an inpatient palliative care service was associated with fewer resuscitation events for hospitalized patients and a trend toward better outcomes, particularly for elderly patients.