von Saß Christiane, Tenge Theresa, van Oorschot Birgitt, Pieper Dawid, Eisenmenger Nicole, Heinze Martin, Fink Larissa, Michels Guido, Neukirchen Martin, Kamp Marcel A
Palliative Care, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Rüdersdorf bei, Berlin, Germany.
Interdisciplinary Centre for Palliative Care, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD), Düsseldorf, Germany.
BMC Palliat Care. 2025 Mar 20;24(1):74. doi: 10.1186/s12904-025-01718-1.
Despite rising importance of integration of palliative medicine in treating life-threatening illnesses in intensive care units (ICU), the extent remains unknown. Using billing data, we analysed the frequency of specialized palliative care use in ICU patients in Germany.
Billing data (2019 -2022) from the InEK was used in this cross-sectional study on all billed adult ICU cases. Data included case numbers, demographics, diagnoses, treatment procedures, ventilation (≥ 95 h), palliative care frequency.
61,591,299 adult cases were treated, 11.2% (6,912,316) requiring ICU and 499,262 (7.2%) needing long-term ventilation. 44.2% of all ICU cases and 36.2% of long-term ventilated patients were female (p < 0.0001). ICU mortality was 11.1%, long-term ventilation mortality was 38.8%; higher in men and patients aged ≥ 65 (p < 0.001). Leading diagnoses for ICU deaths: heart failure (6.9%), stroke (6.3%), sepsis (6.2%). 0.8% of ICU cases and 1.4% of long-term ventilated cases received specialized palliative care, with a higher proportion of females (p < 0.0001). Most palliative care patients were aged ≥ 65.
From 2019 to 2022, 11.2% of hospital cases required ICU-treatment. Despite suffering from life-threatening conditions and high mortality rates, less than 1% of all ICU cases and 1.4% of long-term ventilated cases received palliative care (differing sexes and ages). This highlights deficiencies in palliative care integration into ICUs to alleviate patients and their families suffering from complex needs. Implementing benchmarking could be beneficial in this process.
尽管姑息医学在重症监护病房（ICU）治疗危及生命的疾病中日益重要，但其应用程度仍不明确。我们利用计费数据，分析了德国ICU患者使用专科姑息治疗的频率。
本横断面研究使用了来自InEK的计费数据（2019 - 2022年），涵盖所有计费的成人ICU病例。数据包括病例数、人口统计学信息、诊断、治疗程序、通气时间（≥95小时）、姑息治疗频率。
共治疗了61,591,299例成人病例，其中11.2%（6,912,316例）需要入住ICU，499,262例（7.2%）需要长期通气。所有ICU病例中44.2%为女性，长期通气患者中36.2%为女性（p < 0.0001）。ICU死亡率为11.1%，长期通气死亡率为38.8%；男性和年龄≥65岁的患者死亡率更高（p < 0.001）。ICU死亡的主要诊断为：心力衰竭（6.9%）、中风（6.3%）、败血症（6.2%）。0.8%的ICU病例和1.4%的长期通气病例接受了专科姑息治疗，女性比例更高（p < 0.0001）。大多数接受姑息治疗的患者年龄≥65岁。
2019年至2022年期间，11.2%的住院病例需要ICU治疗。尽管患有危及生命的疾病且死亡率高，但所有ICU病例中不到1%以及长期通气病例中1.4%接受了姑息治疗（性别和年龄存在差异）。这凸显了在将姑息治疗纳入ICU以减轻患者及其家庭复杂需求方面存在的不足。在此过程中实施基准评估可能会有所帮助。
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