Palliative Care Involvement in Patients Hospitalized in the United States with Aneurysmal Subarachnoid Hemorrhage

摘要

Background: Aneurysmal subarachnoid hemorrhage (aSAH) has a high mortality rate and significantly impacts survivors' quality of life.Objective: To assess impact of specialty palliative care services (sPCS) among patients hospitalized with aSAH.Design: A retrospective cohort study using the National Inpatient Sample (2017–2018).Setting/Subjects: U.S. adult patients hospitalized for aSAH with and without sPCS involvement.Measurements: Mortality and health care utilization variables.Results: Among 48,050 patients with aSAH, 12.7% received sPCS input. aSAH patients with sPCS were more likely to be sicker (higher National Inpatient Sample-subarachnoid hemorrhage [NIS-SAH] severity score, p < 0.01). Patients with sPCS had a 70% in-hospital mortality rate, whereas only 9% of the rest of this cohort died during the incident hospitalization (p < 0.01). Those with sPCS involvement had shorter lengths of stay (p < 0.05) and nonsignificantly lower hospital charges.Conclusion: sPCS involvement, inferred by International Classification of Diseases, 10th Revision (ICD-10) code Z51.5, was associated with shorter length of stay and lower hospital charges among survivors, but this did not meet prespecified statistical significance. There may be significant benefits to consulting sPCS for patients hospitalized with aSAH.