Breana L Taylor1, David L O'Riordan2, Steven Z Pantilat2, Claire J Creutzfeldt2. 1. From the Department of Neurology (B.L.T., C.J.C.), University of Washington, Seattle; and Department of Medicine (D.L.O., S.Z.P.), Division of Palliative Medicine, University of California San Francisco. btaylor6@uw.edu. 2. From the Department of Neurology (B.L.T., C.J.C.), University of Washington, Seattle; and Department of Medicine (D.L.O., S.Z.P.), Division of Palliative Medicine, University of California San Francisco.
Abstract
OBJECTIVES: To compare characteristics and needs of inpatients with neurologic disease to those with cancer referred for palliative care (PC) consultation. METHODS: This prospective cohort study used data collected by the Palliative Care Quality Network from January 2013 until December 2016. We compared demographics, reasons for consultation, discharge disposition, Palliative Performance Scale (PPS) score, and outcomes of care among patients with a primary diagnosis of neurologic disease vs cancer. RESULTS: The most common reason for PC consultation in all patients was assistance with goals of care and advanced care planning. PC consultation was less often requested for pain and symptom management in patients with neurologic disease compared to patients with cancer (13.7% vs 43%, odds ratio 0.3) and more often for assistance with transition to comfort measures only and withdrawal of life-sustaining treatment (19.1% vs 7.1%, odds ratio 1.3). Patients with cancer had higher PPS scores (42.1% vs 23.4%) and were more likely to be discharged home from the hospital, while patients with neurologic disease were more likely to die in hospital. CONCLUSIONS: Patients with neurologic disease as a reason for PC consultation are more in need of end-of-life care planning and more likely to die in the hospital than those with cancer, suggesting that targeted approaches may best address the needs of each patient population. Our results can direct further research and education in neuropalliative care.
OBJECTIVES: To compare characteristics and needs of inpatients with neurologic disease to those with cancer referred for palliative care (PC) consultation. METHODS: This prospective cohort study used data collected by the Palliative Care Quality Network from January 2013 until December 2016. We compared demographics, reasons for consultation, discharge disposition, Palliative Performance Scale (PPS) score, and outcomes of care among patients with a primary diagnosis of neurologic disease vs cancer. RESULTS: The most common reason for PC consultation in all patients was assistance with goals of care and advanced care planning. PC consultation was less often requested for pain and symptom management in patients with neurologic disease compared to patients with cancer (13.7% vs 43%, odds ratio 0.3) and more often for assistance with transition to comfort measures only and withdrawal of life-sustaining treatment (19.1% vs 7.1%, odds ratio 1.3). Patients with cancer had higher PPS scores (42.1% vs 23.4%) and were more likely to be discharged home from the hospital, while patients with neurologic disease were more likely to die in hospital. CONCLUSIONS:Patients with neurologic disease as a reason for PC consultation are more in need of end-of-life care planning and more likely to die in the hospital than those with cancer, suggesting that targeted approaches may best address the needs of each patient population. Our results can direct further research and education in neuropalliative care.
Authors: Francis Lau; Michael Downing; Mary Lesperance; Nicholas Karlson; Craig Kuziemsky; Ju Yang Journal: J Pain Symptom Manage Date: 2009-01-26 Impact factor: 3.612
Authors: Claire J Creutzfeldt; Benzi Kluger; Adam G Kelly; Monica Lemmon; David Y Hwang; Nicholas B Galifianakis; Alan Carver; Maya Katz; J Randall Curtis; Robert G Holloway Journal: Neurology Date: 2018-06-27 Impact factor: 9.910
Authors: Jennifer A Frontera; J Randall Curtis; Judith E Nelson; Margaret Campbell; Michelle Gabriel; Anne C Mosenthal; Colleen Mulkerin; Kathleen A Puntillo; Daniel E Ray; Rick Bassett; Renee D Boss; Dana R Lustbader; Karen J Brasel; Stefanie P Weiss; David E Weissman Journal: Crit Care Med Date: 2015-09 Impact factor: 7.598
Authors: Deborah B McGuire; Karen Snow Kaiser; Mary Ellen Haisfield-Wolfe; Florence Iyamu Journal: Nurs Clin North Am Date: 2016-09 Impact factor: 1.208
Authors: Kara E Bischoff; David L O'Riordan; Kristyn Fazzalaro; Anne Kinderman; Steven Z Pantilat Journal: J Pain Symptom Manage Date: 2017-10-10 Impact factor: 3.612
Authors: Steven Z Pantilat; Angela K Marks; Kara E Bischoff; Ashley R Bragg; David L O'Riordan Journal: J Palliat Med Date: 2017-04-06 Impact factor: 2.947
Authors: Maisha T Robinson; Barbara G Vickrey; Robert G Holloway; Kelly Chong; Linda S Williams; Robert H Brook; Mei Leng; Punam Parikh; David S Zingmond Journal: Neurology Date: 2016-04-08 Impact factor: 9.910
Authors: Mary Ersek; Kathleen T Unroe; Joan G Carpenter; John G Cagle; Caroline E Stephens; David G Stevenson Journal: J Am Med Dir Assoc Date: 2021-12-23 Impact factor: 4.669
Authors: Laura Cottrell; Guillaume Economos; Catherine Evans; Eli Silber; Rachel Burman; Richard Nicholas; Bobbie Farsides; Stephen Ashford; Jonathan Simon Koffman Journal: PLoS One Date: 2020-10-16 Impact factor: 3.240