March 2, 2010Annals of Internal Medicine
Brief Communication: Management of Implantable Cardioverter-Defibrillators in Hospice: A Nationwide Survey
Key result
Hospices frequently report recent ICD shocks, yet only ~10% have formal deactivation policies.
- 95% CI 37 to 48
- n=414
Population
414 responding hospices (out of 900 randomly selected nationwide)
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Few hospices have ICD deactivation policies despite frequent shocks; leaves open whether standardized protocols would improve end-of-life care.
Study Design
Type
Cross-Sectional (n=414)
Multicenter
Yes
Structured PICO
P
Population
414 hospice facilities responding to a nationwide survey regarding the management and deactivation of implantable cardioverter-defibrillators.
E
Exposure
Survey on management of implantable cardioverter-defibrillators (ICDs) and deactivation policies
O
Outcome
Frequency of admission of patients with ICDs, frequency with which patients received shocks, existence of ICD deactivation policies, and frequency of deactivation
Despite high rates of ICD patients in hospices and frequent end-of-life shocks, very few hospices have formal ICD deactivation policies.
Limitations
- The study relied on the knowledge of hospice administrators.
Cite This Study
Nathan E. Goldstein (2010) conducted a cross-sectional in Implantable cardioverter-defibrillators in hospice patients (n=414). Hospice care for patients with ICDs was evaluated on Frequency of ICD deactivation (95% CI 37 to 48). In a survey of 414 hospices, 97% admitted patients with ICDs, 58% reported a patient had been shocked in the past year, and only 10% had a policy addressing ICD deactivation.