PMID- 38461106
OWN - NLM
STAT- Publisher
LR  - 20240309
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
DP  - 2024 Mar 8
TI  - Palliative Care Utilisation and Outcomes in Patients Admitted for Heart Failure 
      in a Victorian Healthcare Service.
LID - S1443-9506(24)00052-0 [pii]
LID - 10.1016/j.hlc.2024.01.022 [doi]
AB  - BACKGROUND: Heart failure (HF) has high mortality and healthcare utilisation. It 
      has a complex and unpredictable trajectory, which is often interpreted as a 
      barrier to guideline recommended early integration of palliative care (PC). In 
      particular, lack of referral criteria and misconceptions around PC affect 
      inpatient specialist PC referrals. AIMS: The main objective was to characterise 
      the pattern and predictors of referral of HF patients to the specialist inpatient 
      PC consultative service at our healthcare service. METHODS: A retrospective, 
      single-centre cohort study was performed on consecutive patients admitted across 
      the hospital with HF over a 12-month period (July 2019-June 2020). Mortality data 
      were checked against state death registry data. RESULTS: The 502 patients 
      admitted for HF were elderly (mean age 78+/-14 years), had high dependency (54% 
      Australian-modified Karnofsky Performance Status (AKPS) 50-70, 29% AKPS 10-40), 
      and high mortality (53% within median 32 months at death registry data linkage). 
      Seven per cent (7%) were referred to inpatient specialist PC. AKPS 10-40 (62% of 
      those referred vs 26% not referred, p<0.01), reliance on carers (65% vs 36%, 
      p<0.01), and New York Heart Association (NYHA) class III-IV symptoms (86% vs 42%, 
      p<0.01) were associated with referral, but two or more admissions in the last 12 
      months for HF were not (16% vs 10%, p=0.21). Many PC domains, such as symptom 
      burden, distress, and preferred care, were not adequately assessed. CONCLUSIONS: 
      Referral to inpatient specialist PC in hospitalised HF patients is low relative 
      to the morbidity and mortality in these patients.
CI  - Crown Copyright (c) 2024. Published by Elsevier B.V. All rights reserved.
FAU - Ye, Sylvia
AU  - Ye S
AD  - Department of General Medicine, Alfred Hospital, Melbourne, Vic, Australia; 
      School of Public Health and Preventive Medicine, Monash University, Melbourne, 
      Vic, Australia. Electronic address: sylviacye@gmail.com.
FAU - Corbett, Cathy
AU  - Corbett C
AD  - Department of General Medicine, Alfred Hospital, Melbourne, Vic, Australia; 
      Department of Palliative Care, Alfred Hospital, Melbourne, Vic, Australia.
FAU - Dennis, Adelaide S M
AU  - Dennis ASM
AD  - Department of General Medicine, Alfred Hospital, Melbourne, Vic, Australia.
FAU - Jape, Dylan
AU  - Jape D
AD  - Department of General Medicine, Alfred Hospital, Melbourne, Vic, Australia.
FAU - Patel, Hitesh
AU  - Patel H
AD  - Department of Cardiology, Alfred Hospital, Melbourne, Vic, Australia.
FAU - Zentner, Dominica
AU  - Zentner D
AD  - Department of Cardiology, Royal Melbourne Hospital, Melbourne, Vic, Australia.
FAU - Hopper, Ingrid
AU  - Hopper I
AD  - Department of General Medicine, Alfred Hospital, Melbourne, Vic, Australia; 
      School of Public Health and Preventive Medicine, Monash University, Melbourne, 
      Vic, Australia.
LA  - eng
PT  - Journal Article
DEP - 20240308
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
OTO - NOTNLM
OT  - Advance care planning
OT  - Heart failure
OT  - Palliative care
COIS- Conflicts of Interest There are no conflicts of interest to disclose.
EDAT- 2024/03/10 00:42
MHDA- 2024/03/10 00:42
CRDT- 2024/03/09 21:55
PHST- 2023/09/14 00:00 [received]
PHST- 2023/12/22 00:00 [revised]
PHST- 2024/01/11 00:00 [accepted]
PHST- 2024/03/10 00:42 [medline]
PHST- 2024/03/10 00:42 [pubmed]
PHST- 2024/03/09 21:55 [entrez]
AID - S1443-9506(24)00052-0 [pii]
AID - 10.1016/j.hlc.2024.01.022 [doi]
PST - aheadofprint
SO  - Heart Lung Circ. 2024 Mar 8:S1443-9506(24)00052-0. doi: 
      10.1016/j.hlc.2024.01.022.