Ali Hassam, Pamarthy Rahul, Bolick Nicole Leigh, Leland William, Lee Tae
Department of Internal Medicine, East Carolina University/Vidant Medical Center, Greenville, North Carolina.
Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, Florida.
Proc (Bayl Univ Med Cent). 2022 Aug 11;35(6):762-767. doi: 10.1080/08998280.2022.2106537. eCollection 2022.
Intensive care units (ICUs) account for a disproportionately large share of healthcare utilization. Our study examined the association between palliative care consults (PCC) and hospital outcomes in mechanically ventilated patients. We analyzed patients admitted from 2016 to 2019 using the National Inpatient Sample database. The primary outcome was the association of PCC and length of stay; secondary outcomes included the impact of PCC on total hospital costs. Of the 2,351,503 patients included, 15.5% had a PCC, with a male predominance (53%, < 0.001). Whites had a higher PCC rate, at 167 per 1000 ICU cases, vs. Blacks, at 25 per 1000 cases ( < 0.001). Adjusted length of stay was 2.0 days less in patients with PCC ( < 0.001), and adjusted inpatient hospital cost was $12,942 lower in patients with PCC ( < 0.001). Whites had a larger decrease in length of stay and costs compared to blacks, Hispanics, and Asians ( < 0.001). In conclusion, PCC was associated with a shorter length of stay and lower inpatient hospital costs in critically ill ICU patients. Black patients saw a lower impact of PCC on LOS and hospital costs, as well as a lower rate of PCC.
重症监护病房（ICU）在医疗资源利用中所占比例过高。我们的研究调查了姑息治疗会诊（PCC）与机械通气患者的医院结局之间的关联。我们使用国家住院样本数据库分析了2016年至2019年收治的患者。主要结局是PCC与会诊时长的关联；次要结局包括PCC对医院总费用的影响。在纳入的2351503例患者中，15.5%接受了PCC，男性占主导（53%，<0.001）。白人的PCC率较高，每1000例ICU病例中有167例，而黑人每1000例中有25例（<0.001）。接受PCC的患者调整后的住院时长缩短了2.0天（<0.001），调整后的住院费用降低了12942美元（<0.001）。与黑人、西班牙裔和亚裔相比，白人的住院时长和费用下降幅度更大（<0.001）。总之，PCC与重症ICU患者较短的住院时长和较低的住院费用相关。黑人患者中PCC对住院时长和医院费用的影响较小，且PCC率较低。
