Frequency of palliative care patients in a second level intensive care unit: Retrospective study
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Objective: Intensive care units (ICUs) are associated with high mortality rates. Therefore, intensive care physicians should have knowledge in terms of end-of-life care. Palliative care patients are often exposed to aggressive treatments instead of supportive care as they transfer to ICUs in the terminal period of their lives. The main aim of this study is to investigate the frequency, characteristics, duration of ICU stay, primary diseases and outcomes of palliative care patients followed up in our ICU. Method: The data of 173 patients who admitted to the intensive care unit between 01.01.2017 and 08.31.2018 were retrospectively analyzed. According to the criteria set by the World Health Organization; the patients who could be considered as palliative care patients were picked up among the patients who were admitted in the ICU. Patients who met the study criteria were classified into two groups as palliative care patients (study group) and intensive care patients (control group). Sixty-two patients (39%) who met the palliative care criteria were accepted as the study group. The frequency, demographic characteristics, ICU stay times, diagnosis, APACHE II scores, death or discharge status of palliative care patients were listed. Results: The mean age, causes of mortality, ICU stay and discharge rates were significantly different between the two groups. Most of the study group had advanced neurological diseases and terminal period of cancer. It was observed that the patients in the study group occupied 55% of the total ICU bed days. Conclusion: In order to improve the quality of end-of-life care, to raise the awareness of ICU doctors about end-of-life care, to implement end-of-life decisions, to increase the number of beds of the palliative care unit, and to determine the guidelines in the decisions to be used in the care of palliative care patients and in intensive care admissions. Thus, inappropriate use of ICUs may be prevented. © 2019 Copyright Anesthesiology and Reanimation Specialists' Society.