Key result
Palliative care consultation was received by 42% of patients undergoing cardiac device deactivation, with no difference in survival between groups (median survival 2 days).
Why the study?
Does palliative care/medicine consultation affect survival in patients undergoing pacemaker or implantable cardioverter-defibrillator deactivation?
Cohort (n=150)
No
Does palliative care/medicine consultation affect survival in patients undergoing pacemaker or implantable cardioverter-defibrillator deactivation?
Palliative care consultation is utilized in nearly half of patients undergoing cardiac device deactivation, though it does not impact short-term survival, which is typically very brief (median 2 days).
Palliative care uptake in device deactivation remains suboptimal; leaves open effects on care quality in this observational cohort.
The presence of cardiac pacemakers and defibrillators complicates making end-of-life (EOL) medical decisions. Palliative care/medicine consultation (PCMC) may benefit patients and primary providers, but data are lacking. We retrospectively reviewed 150 charts of patients who underwent device deactivation at our tertiary care center (between November 1, 2008, and September 1, 2012), assessing for PCMC and outcomes. Overall, 42% of patients received a PCMC, and 68% of those PCMCs specifically addressed device deactivation. Median survival following deactivation was 2 days, with 42% of deaths occurring within 1 day of deactivation. There was no difference in survival between the groups. The EOL care for patients with implanted cardiac devices is complex, but PCMC may assist with symptom management and clarification of goals of care for such patients.
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Pasalic et al. (2015) conducted a cohort in Cardiac pacemaker or implantable cardioverter-defibrillator deactivation (n=150). Palliative care/medicine consultation vs. No palliative care consultation was evaluated on Survival following deactivation. Palliative care consultation was received by 42% of patients undergoing cardiac device deactivation, with no difference in survival between groups (median survival 2 days).
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