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Revista Médica del Uruguay

versión impresa ISSN 0303-3295versión On-line ISSN 1688-0390

Resumen

MOREIRA, Eduardo et al. Assessment of consultation triggers to optimize the opportunity to access palliative care in the ICU. Rev. Méd. Urug. [online]. 2021, vol.37, n.1, e204.  Epub 01-Mar-2021. ISSN 0303-3295.  http://dx.doi.org/10.29193/rmu.37.1.4.

Introduction:

palliative care (PC) constitutes a marker of the quality of intensive care assistance. However, it has not been thoroughly assessed in Uruguay. Proactive detection of patients by means of “consultation triggers” should be considered a strategy to optimize access to PC.

Objetives:

to determine the prevalence and characteristics of Palliative Care consultation triggers in critical patients. To analyse the use of resources in these patients.

Method:

retrospective cohort study of patients admitted in the ICU between March 2016 and February 2019. The following triggers were identified: a) a tumor with metastasis; length of stay at the ICU 50% over the average (14 days), c) >75 years old with multiple organic dysfunction and d) >80 years old with 2 or more severe comorbidities

Results: 2.850 patients were analysed. 26% (734) presented at least one consultation trigger with PC. Length of stay at the ICU 50% over average (18%). These patients presented higher average age 61 (43-75) versus 54 (36-65) years old (p < 0.001), and increased severity, SAPSIII of 60 (48-74) compared to 47 (35-61) points (p<0.001); 87% required mechanical ventilation compared to 55% (p <0.001), vasopressors 48% compared to 24% (p< 0.001) and hemodialysis 8% compared to 4% (p<0.001). 18 presented a longer stay (9-27) compared to 4 (2-8) days, (p<0.001) and time on mechanical ventilation 14 (7-23) compared to 3 (1- 6) days (p<0.001).

Conclusions:

25 percent of patients in the ICU activated at least one criterion for PC, they were in a more severe condition and used more mechanical ventilation.

Palabras clave : Critical care; Palliative care; Query trigger valuation.

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