Division of Geriatrics, Gerontology and Palliative Medicine, The University of Texas Health Science Center, San Antonio, Texas 78229, USA.
J Pain Symptom Manage. 2011 Nov;42(5):676-9. doi: 10.1016/j.jpainsymman.2011.07.004.
Only a minority of patients who die in the medical intensive care unit (MICU) receive palliative care services. At the South Texas Veterans Health Care System Audie L. Murphy Hospital, only 5% of patients who died in the MICU from May to August 2010 received a palliative care consultation.
We measured the percentage of MICU patients for which there was a palliative care consultation during the intervention period.
Starting October 1, 2010 and ending April 30, 2011, the palliative care and MICU teams participated in daily "pre-rounds" to identify patients at risk for poor outcomes, who may benefit from a palliative care consultation.
Palliative care consultation increased significantly from 5% to 59% for patients who died in the MICU during the intervention period. Additionally, palliative care consultation increased from 5% to 21% for all patients admitted to the MICU during the intervention period.
CONCLUSIONS/LESSONS LEARNED: Daily pre-rounds between the palliative care and MICU teams increased palliative care services for MICU patients at risk for poor outcomes, who may benefit from a palliative care consultation.
只有少数在重症监护病房（MICU）死亡的患者接受姑息治疗服务。在南德克萨斯州退伍军人医疗保健系统奥狄·L·墨菲医院，2010 年 5 月至 8 月期间，在 MICU 死亡的患者中只有 5%接受了姑息治疗咨询。
我们测量了干预期间接受姑息治疗咨询的 MICU 患者的百分比。
从 2010 年 10 月 1 日至 2011 年 4 月 30 日，姑息治疗和 MICU 团队每天进行“预查房”，以确定有不良预后风险、可能受益于姑息治疗咨询的患者。
在干预期间，MICU 死亡患者的姑息治疗咨询比例从 5%显著增加到 59%。此外，在干预期间，所有入住 MICU 的患者的姑息治疗咨询比例从 5%增加到 21%。
结论/经验教训：姑息治疗和 MICU 团队之间的每日预查房增加了有不良预后风险、可能受益于姑息治疗咨询的 MICU 患者的姑息治疗服务。
