Palliative Care Consults for Critically Ill Patients, Does Timing Matter? (GP139)

Outcomes 1. Compare sociodemographic and clinical characteristics of patients who received palliative care consults during their medical intensive care unit (MICU) stay versus after their ICU stay. 2. Examined the impact that the timing of the palliative care consultation ( during ICU versus after ICU) has on patient outcome. Key Message Critically ill patients in the MICU have a high mortality rate. No specific indicators are helpful in determining which critically ill patients require an in-ICU consult. Therefore, even in the setting of limited resources, models need to be developed to ensure all patients in the MICU receive an in-ICU consult. Importance Although palliative care is crucial for critically ill patients, even with an embedded palliative care team, not all patients receive an in-ICU palliative care consult. Objective(s) 1. Compare sociodemographic and clinical characteristics of patients who received an in-ICU versus post-ICU palliative care consult, 2. Examined the impact that the timing of the palliative care consultation (during ICU versus after ICU) has on patient outcome. Scientific Methods Utilized We conducted a retrospective cohort study of patients in our palliative care consultation registry who had a MICU length of stay (LOS) > 72 hours at Mount Sinai Hospital in 2022. We used EHR and administrative data to compare the sociodemographic and clinical characteristics of patients who received an in-ICU palliative care consult and those who received a post-ICU consult. We compared ICU and hospital LOS, time from consult to discharge, and in-hospital mortality. Results Overall, 195 patients received an in-ICU palliative care consultation and 63 had a post-ICU consultation. There were no sociodemographic or clinical differences (e.g., age, gender, race, primary language, insurance, functional status, serious illnesses, comorbidity index) among patients who received an in-ICU consult and those who received a post-ICU consult. As compared to the in-ICU consult group, patients who received a post-ICU consult were less likely to have life-prolonging goals (25.4% vs 40%, p Conclusion(s) Our findings suggest that sociodemographic and clinical indicators do not distinguish which patients need an in-ICU consult. Yet, all patients in this sample have a high in-hospital mortality rate regardless of consult timing. Impact Models are needed to ensure all patients with a MICU LOS > 72 hours receive an in-ICU palliative care consult.