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Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States

Background: This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. Methods: Using the National Inpatient Sample, hospital...

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Autores principales: Thongprayoon, Charat, Kaewput, Wisit, Petnak, Tananchai, O’Corragain, Oisin A., Boonpheng, Boonphiphop, Bathini, Tarun, Vallabhajosyula, Saraschandra, Pattharanitima, Pattharawin, Lertjitbanjong, Ploypin, Qureshi, Fawad, Cheungpasitporn, Wisit
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150700/
https://www.ncbi.nlm.nih.gov/pubmed/34065828
http://dx.doi.org/10.3390/medicines8050021
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author Thongprayoon, Charat
Kaewput, Wisit
Petnak, Tananchai
O’Corragain, Oisin A.
Boonpheng, Boonphiphop
Bathini, Tarun
Vallabhajosyula, Saraschandra
Pattharanitima, Pattharawin
Lertjitbanjong, Ploypin
Qureshi, Fawad
Cheungpasitporn, Wisit
author_facet Thongprayoon, Charat
Kaewput, Wisit
Petnak, Tananchai
O’Corragain, Oisin A.
Boonpheng, Boonphiphop
Bathini, Tarun
Vallabhajosyula, Saraschandra
Pattharanitima, Pattharawin
Lertjitbanjong, Ploypin
Qureshi, Fawad
Cheungpasitporn, Wisit
author_sort Thongprayoon, Charat
collection PubMed
description Background: This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. Methods: Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. Results: Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (p < 0.001). Older age, more recent year of hospitalization, acute liver failure, alcoholic cirrhosis, and hepatocellular carcinoma were predictive of increased palliative care service use, whereas race other than Caucasian, African American, and Hispanic and chronic kidney disease were predictive of decreased palliative care service use. Although hospital admission with palliative care service use had higher mortality, palliative care service was associated with lower use of invasive mechanical ventilation, blood product transfusion, paracentesis, renal replacement, vasopressor but higher DNR status. Palliative care services reduced mean length of hospital stay and hospitalization cost. Conclusion: Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use.
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spelling pubmed-81507002021-05-27 Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States Thongprayoon, Charat Kaewput, Wisit Petnak, Tananchai O’Corragain, Oisin A. Boonpheng, Boonphiphop Bathini, Tarun Vallabhajosyula, Saraschandra Pattharanitima, Pattharawin Lertjitbanjong, Ploypin Qureshi, Fawad Cheungpasitporn, Wisit Medicines (Basel) Article Background: This study aimed to determine the rates of inpatient palliative care service use and assess the impact of palliative care service use on in-hospital treatments and resource utilization in hospital admissions for hepatorenal syndrome. Methods: Using the National Inpatient Sample, hospital admissions with a primary diagnosis of hepatorenal syndrome were identified from 2003 through 2014. The primary outcome of interest was the temporal trend and predictors of inpatient palliative care service use. Logistic and linear regression was performed to assess the impact of inpatient palliative care service on in-hospital treatments and resource use. Results: Of 5571 hospital admissions for hepatorenal syndrome, palliative care services were used in 748 (13.4%) admissions. There was an increasing trend in the rate of palliative care service use, from 3.3% in 2003 to 21.1% in 2014 (p < 0.001). Older age, more recent year of hospitalization, acute liver failure, alcoholic cirrhosis, and hepatocellular carcinoma were predictive of increased palliative care service use, whereas race other than Caucasian, African American, and Hispanic and chronic kidney disease were predictive of decreased palliative care service use. Although hospital admission with palliative care service use had higher mortality, palliative care service was associated with lower use of invasive mechanical ventilation, blood product transfusion, paracentesis, renal replacement, vasopressor but higher DNR status. Palliative care services reduced mean length of hospital stay and hospitalization cost. Conclusion: Although there was a substantial increase in the use of palliative care service in hospitalizations for hepatorenal syndrome, inpatient palliative care service was still underutilized. The use of palliative care service was associated with reduced resource use. MDPI 2021-05-12 /pmc/articles/PMC8150700/ /pubmed/34065828 http://dx.doi.org/10.3390/medicines8050021 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Thongprayoon, Charat
Kaewput, Wisit
Petnak, Tananchai
O’Corragain, Oisin A.
Boonpheng, Boonphiphop
Bathini, Tarun
Vallabhajosyula, Saraschandra
Pattharanitima, Pattharawin
Lertjitbanjong, Ploypin
Qureshi, Fawad
Cheungpasitporn, Wisit
Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title_full Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title_fullStr Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title_full_unstemmed Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title_short Impact of Palliative Care Services on Treatment and Resource Utilization for Hepatorenal Syndrome in the United States
title_sort impact of palliative care services on treatment and resource utilization for hepatorenal syndrome in the united states
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150700/
https://www.ncbi.nlm.nih.gov/pubmed/34065828
http://dx.doi.org/10.3390/medicines8050021
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