Intensive care utilization among patients with heart failure in their last month of life remained high, with 53.27% admitted to ICUs and only 0.87% receiving hospice care between 2001 and 2013.
Observational (n=25,375)
What are the trends in intensive care and hospice utilization for patients with heart failure in their last month of life?
Despite decreases in mechanical ventilation and CPR, intensive care utilization remains high and hospice care remains inadequate for patients with heart failure in their last month of life.
A good death is a human right. Unfortunately, patients with chronic heart failure (CHF) in the terminal stage still receive inappropriate life-sustaining treatment before death. There is limited understanding of the status of intensive care unit (ICU) admission, mechanical ventilation (MV), cardiopulmonary resuscitation (CPR), and even extracorporeal membrane oxygenation (ECMO) for patients with CHF before death, as well as their use of hospice-related services. This study investigated the trends and trend changes in intensive procedures and hospice-related services for patients with CHF in the last month of life. This population-based retrospective observational study included 25 375 patients with CHF from the National Health Insurance research database in Taiwan and collected information on their intensive treatments during the last month of life. We computed intensive treatment utilization rates and analyzed the trends and trend changes via joinpoint regression. The average percentage of patients with CHF admitted to ICUs was 53.27% (n = 13 516). A total of 327 (1.29%) patients with CHF received ECMO. The percentages of patients receiving MV (54.3%'41.5%) and CPR (41.5%'17%) decreased over time. Conversely, the percentage of ECMO use (0.52%'1.78%) increased. However, only 222 (0.87%) patients with CHF received hospice care in the last month of life between 2001 and 2013. The rates of ICU admission and life-sustaining treatment among patients with CHF in the month before death remain high, and hospice-related services remain inadequate. This study highlights the need for research and training in providing palliative and hospice care for patients with CHF.
Chou et al. (Mon,) conducted a observational in Chronic heart failure (n=25,375). Intensive care and life-sustaining treatments was evaluated on Utilization rates and trends of intensive procedures and hospice-related services. Intensive care utilization among patients with heart failure in their last month of life remained high, with 53.27% admitted to ICUs and only 0.87% receiving hospice care between 2001 and 2013.