To investigate, researchers conducted a retrospective analysis of New York University Langone Health’s electronic health data of COVID-19 hospitalizations between March 2, 2020 and August 25, 2020.
These data pertained to three acute care hospitals located in Manhattan, Brooklyn, and Long Island.Of 4,276 patients with COVID-19, 1,310 (31%) developed AKI.
Compared with those without AKI, individuals with AKI received more palliative care consults (42% vs. 7%), but they occurred significantly later (10 days from hospital admission vs. 5 days).
Those with AKI had 1.81-times higher odds of receiving palliative care than those without AKI, even after controlling for markers of critical illness (such as admission to intensive care units or the use of mechanical ventilation).
66% of patients with AKI who initiated kidney replacement therapy (KRT) such as dialysis received palliative care vs. 37% of those with AKI not receiving KRT.
Palliative care consults also occurred later for those who were started on KRT compared with those who were not (12 days from admission vs. 9 days).
Despite greater use of palliative care, patients with AKI had a significantly longer length of hospital stay, more intensive care unit admissions, and more use of mechanical ventilation.
Compared with those without AKI, a higher proportion of those with AKI died during hospitalization (46% vs. 5%) or were discharged to inpatient hospice (6% vs. 3%), while a lower proportion was discharged home (24% vs. 77%).
However, given the high mortality, it does suggest that patients and families could have benefited from earlier support from palliative care.
Palliative care supports primary doctors in caring for seriously ill patients by managing emotional and physical symptoms while also assisting in advance care planning. Importantly, it can be incorporated into the care plan of someone who is pursuing curative care and can be helpful in an acute and possibly reversible situation.
Source: Medindia
