Lawrence Asprec1, Craig D Blinderman1, Ana Berlin1,2, Mary E Callahan1, Eric Widera3,4, Vyjeyanthi S Periyakoil5,6, Alexander K Smith3,4, Shunichi Nakagawa1. 1. Adult Palliative Care Service, Department of Medicine, Department of Surgery, Columbia University Irving Medical Center, New York, New York, USA. 2. Division of General Surgery, Department of Surgery, Columbia University Irving Medical Center, New York, New York, USA. 3. Division of Geriatrics, Department of Medicine, University of California San Francisco, San Francisco, California, USA. 4. Geriatrics, Palliative, and Extended Care Service, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA. 5. Department of Medicine, Stanford University, Palo Alto, California, USA. 6. Extended Care and Palliative Medicine Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA.
Abstract
Context: Amid the COVID-19 surge in New York City, the need for palliative care was highlighted. Virtual consultation was introduced to expand specialist-level care to meet demand. Objectives: To examine the outcomes of COVID-19 patients who received virtual palliative care consultation from outside institutions. Design: This is a retrospective case series. Setting/Subjects: Subjects were 34 patients who received virtual palliative care consultation between April 13, 2020, and June 14, 2020. Measurements: Follow-up frequency and duration, code status change, withdrawal of life-sustaining treatment (LST), and multidisciplinary involvement. Results: Twenty-eight patients (82.3%) were in the intensive care unit and 29 patients (85.3%) were on at least two LSTs. Fifteen patients (44.1%) died in the hospital, 9 patients (26.4%) were discharged alive, and 10 patients (29.4%) were signed off. The median frequency of visits was 4.5 (IQR 6) over 11 days follow-up (IQR 17). Code status change was more frequent in deceased patients. LSTs were withdrawn in eight patients (23.5%). Conclusions: Virtual palliative care consultation was feasible during the height of the COVID-19 pandemic.
Context: Amid the COVID-19 surge in New York City, the need for palliative care was highlighted. Virtual consultation was introduced to expand specialist-level care to meet demand. Objectives: To examine the outcomes of COVID-19 patients who received virtual palliative care consultation from outside institutions. Design: This is a retrospective case series. Setting/Subjects: Subjects were 34 patients who received virtual palliative care consultation between April 13, 2020, and June 14, 2020. Measurements: Follow-up frequency and duration, code status change, withdrawal of life-sustaining treatment (LST), and multidisciplinary involvement. Results: Twenty-eight patients (82.3%) were in the intensive care unit and 29 patients (85.3%) were on at least two LSTs. Fifteen patients (44.1%) died in the hospital, 9 patients (26.4%) were discharged alive, and 10 patients (29.4%) were signed off. The median frequency of visits was 4.5 (IQR 6) over 11 days follow-up (IQR 17). Code status change was more frequent in deceased patients. LSTs were withdrawn in eight patients (23.5%). Conclusions: Virtual palliative care consultation was feasible during the height of the COVID-19 pandemic.
Entities:
Keywords:
COVID-19; digital health; palliative care; telehealth
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