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Patient Risk Factor Profiles Associated With Timing of Goals-of-Care Consultation Before Death

机译:与死亡前的护理目标咨询的时间相关的患者危险因素概况

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Abstract Early palliative care consultation to discuss goals-of-care (“PCC”) benefits seriously ill patients. To identify risk factor profiles associated with inpatient PCC timing before death, we conducted a secondary analysis of seriously ill adults who had PCC at a high-acuity hospital and died 2014-2016. Of 1,141 patients, 54% had PCC “close to death” (0-14 days before death); 26% had PCC 15-60 days before death; 21% had PCC 60 days before death (median 13 days). Classification and Regression Tree modeling showed Hispanic or “Other” race/ethnicity intensive care patients with extreme illness severity (85%) were most likely to have PCC close to death, with age 75 increasing probability (98%). Among age groups, the highest proportion of patients with PCC close to death was 75 years. Complex variable interactions associated with PCC timing suggests we need a systematic process for initiating PCC earlier and effective primary palliative training for providers across settings.
机译:摘要早期姑息治疗咨询讨论护理目标(“PCC”)益处重视患者。为了识别死亡前与入住PCC时序相关的风险因素谱,我们对在高敏金医院的PCC进行了重症的病人进行了次要分析,并在2014-2016中死亡。 1,141名患者中,54%的PCC“接近死亡”(死亡前0-14天); 26%的PCC 15-60天死后; 21%的PCC>死亡前60天(中位数13天)。分类和回归树建模显示西班牙裔或“其他”种族/种族密集型护理患者,极端疾病严重程度(85%)最有可能接近死亡,年龄75岁概率(98%)。在年龄组中,最高比例的PCC患者接近死亡的患者> 75岁。与PCC定时相关的复杂变量交互表明,我们需要一个系统的过程,用于启动PCC,并在跨设置的提供商进行有效的主要群体培训。

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