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Inpatient Palliative Care for Neurological Disorders: Lessons from a Large Retrospective Series
Liu Y, Kline D, Aerts S, Youngwerth JM, Kutner JS, Sillau S, Kluger BM.. Journal of palliative medicine, 2016-11-29
Topic: Risk, prevention and care in population studies
Background Patients with neurological disorders are the second most common patient population to receive inpatient palliative care services after cancer; however, there have been few reports describing the characteristics and needs of this population. Objective To understand which patients with neurological diagnoses utilized these services, reasons for consultation, and whether patterns of use changed over time. Design Retrospective case series. Setting/subjects Neurological patients seen by our academic hospital-based palliative care consult service from January 2010 through December 2014. Measurement Demographics, diagnoses, reasons for consultation, patient characterization, and outcomes were extracted from medical record. Methods Data extracted from the chart was analyzed using primarily descriptive statistics with Chi-square used to compare group proportions and regression to examine temporal trends. Results A total of 3170 patients received inpatient palliative care consultations, of whom 291 (9.2%) had a neurological diagnosis. Among these patients, 85 were excluded because of insufficient data, leaving 206 patients (mean age 70.0 ± 16.0 years; 111 (54%) female). Of the patients, 49% had a chronic diagnosis and 51% received a new diagnosis during their hospitalization, most commonly ischemic stroke. The proportion of patients with chronic diagnoses increased over time, with dementia representing the most common diagnosis in 2014. The most common reason for consultation was eliciting goals of care (82%). Advance directives were present at admission in 61 (30%), 130 (63%) at the time of consultation, and 190 (92%) patients after consultation. The proportion of people with advance directives after consultation significantly increased over the study period (p = 0.01). Discussion Hospital-based palliative care is primarily utilized to clarify goals of care in neurological patients and that advance directives were commonly not completed prior to consultation. Conclusions Outpatient and hospital neurologists should routinely address advance directives, particularly as the proportion of patients with chronic neurological diagnoses increases.
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APA 7th
Liu, Y., Kline, D., Aerts, S., Youngwerth, J. M., Kutner, J. S., Sillau, S., et al. (2017). Inpatient Palliative Care for Neurological Disorders: Lessons from a Large Retrospective Series. Journal of palliative medicine. https://doi.org/10.1089/jpm.2016.0240
Vancouver
Liu Y, Kline D, Aerts S, Youngwerth JM, Kutner JS, Sillau S, et al. Inpatient Palliative Care for Neurological Disorders: Lessons from a Large Retrospective Series. Journal of palliative medicine. 2017. doi:10.1089/jpm.2016.0240. PMID: 27898260.
BibTeX
@article{liu2017-27898260,
author = {Liu, Y. and Kline, D. and Aerts, S. and Youngwerth, J. M. and Kutner, J. S. and Sillau, S. and Kluger, B. M.},
title = {{Inpatient Palliative Care for Neurological Disorders: Lessons from a Large Retrospective Series}},
journal = {Journal of palliative medicine},
year = {2017},
doi = {10.1089/jpm.2016.0240},
pmid = {27898260},
url = {https://doi.org/10.1089/jpm.2016.0240}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Results A total of 3170 patients received inpatient palliative care consultations, of whom 291 (9.2%) had a neurological diagnosis.
- The proportion of people with advance directives after consultation significantly increased over the study period (p = 0.01).
Study details
- Participants3,170
- Effect size9.2%
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 30 of the 58 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of palliative medicine) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,170 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 27898260) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 30 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 30 of the 58 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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