Early Palliative Care Linked to Shorter Stays in ICU

A new study has found that early palliative care interventions can reduce the length of stay for seriously ill patients in the medical intensive care unit (MICU) by more than seven days without having an impact on mortality rates.

Researchers at the University of Rochester Medical Center (URMC; NY, USA) looked at the impact of palliative care interventions on all 191 patients admitted to the MICU at Strong Memorial Hospital (Rochester, NY, USA) between March 2004 and March 2005 identified as having a serious illness and at high risk of dying. Patients admitted during the first phase of the study received a palliative care consultation only after a MICU physician referral, as was the standard practice prior to the study. High-risk patients admitted during the second phase received a proactive palliative care consultation shortly after admission.

Results showed that patients in the proactive phase had significantly shorter lengths of stay in the MICU than those in the first phase, while there was no difference between the two groups on total length of stay in the hospital or mortality rates. The study was published in published in the June 2007 issue of the journal Critical Care Medicine.

"Palliative care is not about giving up on the most aggressive treatment,” said co-author Timothy Quill, M.D., director of the center for ethics, humanities, and palliative care at URMC. "It's about empowering the sickest and most vulnerable patients and their families with the tools and information they need to do what they feel is best. Early palliative care interventions are a value-added service we can provide to these individuals and their families, and improve care in the MICU setting.”

Historically, palliative care has been most strongly associated with end-of-life care with palliative care specialists seeing patients very late in their illness--often after patients had already been in intensive care for two weeks or more or after all other life-prolonging interventions had been exhausted.


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University of Rochester Medical Center