Palliative Family Conference Reduces the Risk of Death in Intensive Care Units and Cardiopulmonary Resuscitation at End of Life

摘要

Background: Palliative family conference (PFC) was included in the reimbursement of National Health Insurance to promote palliative care in Taiwan in 2012.Objectives: This study aimed to evaluate the impact of PFC on death in intensive care unit (ICU) and receiving cardiopulmonary resuscitation (CPR) within three days before death.Design: This is a cross-sectional study.Subjects: All patients who died in a public hospital and were admitted to ICU within 30 days before death, from 2013 to 2018, were included.Measurements: The medical records were analyzed to identify information on causes of death, receiving PFC, receiving palliative care consultation, death in ICU, and receiving CPR within three days before death. Multivariate logistic regression was used to assess the independent effects of receiving PFC on the risk of death in ICU and receiving CPR within three days before death.Results: For patients who died and those who did not die in ICU, the proportion of receiving PFC was 45.8% (1818/3973) and 55.0% (808/1468), respectively. For patients who received and those who did not receive CPR within three days before death, the proportion of receiving PFC was 23.9% (140/585) and 51.2% (2486/4856), respectively. PFC was associated with a reduced risk of death in ICU (adjusted odds ratio [AOR]: 0.842; 95% confidence interval [CI]: 0.717–0.988) and a reduced risk of receiving CPR within three days before death (AOR: 0.361; 95% CI: 0.286–0.456).Conclusion: PFC reduces the risk of receiving nonbeneficial aggressive intervention and may improve the quality of end-of-life care.