Life-sustaining procedures, palliative care consultation, and Do-Not resuscitate status in dying patients with COPD in US Hospitals

2010-2014

Jay J. Shen, Eunjeong Ko, Pearl Kim, Sun Jung Kim, Yongjae Lee, Jae Hoon Lee, Ji Won Yoo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. Materials and Methods: A retrospective nationwide cohort analysis was performed using weighted National Inpatient Sample (NIS) data obtained from 2010 to 2014. Decedents _18 years of age at the time of death and with a principal diagnosis of COPD were included. We examined the receipt of life-sustaining procedures, defined as1 ventilation (intubation, mechanical ventilation, and noninvasive ventilation),2 vasopressor use (infusion and intravascular monitoring),3 nutrition (enteral and parenteral infusion of concentrated nutrition),4 dialysis, and5 cardiopulmonary resuscitation as well as palliative care consultation and do not resuscitate (DNR). We used compound annual growth rates (CAGRs) and the Rao-Scott correction of the w2 statistic to determine the statistical significance of temporal trends of lifesustaining procedures, palliative care utilization, and DNR status. Results: Among 37 312 324 hospitalizations, 38 425 patients were examined. The CAGRs of life-sustaining procedures were 6.61% and _9.73% among patients who underwent multiple procedures and patients who did not undergo any procedure, respectively (both P <.001). The CAGRs of palliative consultation and DNR were 5.25% and 36.62%, respectively (both P <.001). Conclusions: Among adults with COPD dying in US hospitals between 2010 and 2014, the utilization of life-sustaining procedures, palliative care, and DNR status increased.

Original languageEnglish
Pages (from-to)159-166
Number of pages8
JournalJournal of Palliative Care
Volume33
Issue number3
DOIs
Publication statusPublished - 2018 Jan 1

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Palliative Care
Chronic Obstructive Pulmonary Disease
Referral and Consultation
Growth
Parenteral Infusions
Noninvasive Ventilation
Cardiopulmonary Resuscitation
Enteral Nutrition
Artificial Respiration
Intubation
Ventilation
Inpatients
Dialysis
Hospitalization
Cohort Studies
Population

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Shen, Jay J. ; Ko, Eunjeong ; Kim, Pearl ; Kim, Sun Jung ; Lee, Yongjae ; Lee, Jae Hoon ; Yoo, Ji Won. / Life-sustaining procedures, palliative care consultation, and Do-Not resuscitate status in dying patients with COPD in US Hospitals : 2010-2014. In: Journal of Palliative Care. 2018 ; Vol. 33, No. 3. pp. 159-166.
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title = "Life-sustaining procedures, palliative care consultation, and Do-Not resuscitate status in dying patients with COPD in US Hospitals: 2010-2014",
abstract = "Aim: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. Materials and Methods: A retrospective nationwide cohort analysis was performed using weighted National Inpatient Sample (NIS) data obtained from 2010 to 2014. Decedents _18 years of age at the time of death and with a principal diagnosis of COPD were included. We examined the receipt of life-sustaining procedures, defined as1 ventilation (intubation, mechanical ventilation, and noninvasive ventilation),2 vasopressor use (infusion and intravascular monitoring),3 nutrition (enteral and parenteral infusion of concentrated nutrition),4 dialysis, and5 cardiopulmonary resuscitation as well as palliative care consultation and do not resuscitate (DNR). We used compound annual growth rates (CAGRs) and the Rao-Scott correction of the w2 statistic to determine the statistical significance of temporal trends of lifesustaining procedures, palliative care utilization, and DNR status. Results: Among 37 312 324 hospitalizations, 38 425 patients were examined. The CAGRs of life-sustaining procedures were 6.61{\%} and _9.73{\%} among patients who underwent multiple procedures and patients who did not undergo any procedure, respectively (both P <.001). The CAGRs of palliative consultation and DNR were 5.25{\%} and 36.62{\%}, respectively (both P <.001). Conclusions: Among adults with COPD dying in US hospitals between 2010 and 2014, the utilization of life-sustaining procedures, palliative care, and DNR status increased.",
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Life-sustaining procedures, palliative care consultation, and Do-Not resuscitate status in dying patients with COPD in US Hospitals : 2010-2014. / Shen, Jay J.; Ko, Eunjeong; Kim, Pearl; Kim, Sun Jung; Lee, Yongjae; Lee, Jae Hoon; Yoo, Ji Won.

In: Journal of Palliative Care, Vol. 33, No. 3, 01.01.2018, p. 159-166.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Life-sustaining procedures, palliative care consultation, and Do-Not resuscitate status in dying patients with COPD in US Hospitals

T2 - 2010-2014

AU - Shen, Jay J.

AU - Ko, Eunjeong

AU - Kim, Pearl

AU - Kim, Sun Jung

AU - Lee, Yongjae

AU - Lee, Jae Hoon

AU - Yoo, Ji Won

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Aim: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. Materials and Methods: A retrospective nationwide cohort analysis was performed using weighted National Inpatient Sample (NIS) data obtained from 2010 to 2014. Decedents _18 years of age at the time of death and with a principal diagnosis of COPD were included. We examined the receipt of life-sustaining procedures, defined as1 ventilation (intubation, mechanical ventilation, and noninvasive ventilation),2 vasopressor use (infusion and intravascular monitoring),3 nutrition (enteral and parenteral infusion of concentrated nutrition),4 dialysis, and5 cardiopulmonary resuscitation as well as palliative care consultation and do not resuscitate (DNR). We used compound annual growth rates (CAGRs) and the Rao-Scott correction of the w2 statistic to determine the statistical significance of temporal trends of lifesustaining procedures, palliative care utilization, and DNR status. Results: Among 37 312 324 hospitalizations, 38 425 patients were examined. The CAGRs of life-sustaining procedures were 6.61% and _9.73% among patients who underwent multiple procedures and patients who did not undergo any procedure, respectively (both P <.001). The CAGRs of palliative consultation and DNR were 5.25% and 36.62%, respectively (both P <.001). Conclusions: Among adults with COPD dying in US hospitals between 2010 and 2014, the utilization of life-sustaining procedures, palliative care, and DNR status increased.

AB - Aim: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in US hospitals. We examined temporal trends and the impact of palliative care on the use of life-sustaining procedures in this population. Materials and Methods: A retrospective nationwide cohort analysis was performed using weighted National Inpatient Sample (NIS) data obtained from 2010 to 2014. Decedents _18 years of age at the time of death and with a principal diagnosis of COPD were included. We examined the receipt of life-sustaining procedures, defined as1 ventilation (intubation, mechanical ventilation, and noninvasive ventilation),2 vasopressor use (infusion and intravascular monitoring),3 nutrition (enteral and parenteral infusion of concentrated nutrition),4 dialysis, and5 cardiopulmonary resuscitation as well as palliative care consultation and do not resuscitate (DNR). We used compound annual growth rates (CAGRs) and the Rao-Scott correction of the w2 statistic to determine the statistical significance of temporal trends of lifesustaining procedures, palliative care utilization, and DNR status. Results: Among 37 312 324 hospitalizations, 38 425 patients were examined. The CAGRs of life-sustaining procedures were 6.61% and _9.73% among patients who underwent multiple procedures and patients who did not undergo any procedure, respectively (both P <.001). The CAGRs of palliative consultation and DNR were 5.25% and 36.62%, respectively (both P <.001). Conclusions: Among adults with COPD dying in US hospitals between 2010 and 2014, the utilization of life-sustaining procedures, palliative care, and DNR status increased.

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DO - 10.1177/0825859718777375

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JO - Journal of Palliative Care

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