Trends and Changes in Intensive Care Use for Patients With Heart Failure in the Last Month of Life

Bibliographic Data

ID13774617
AuthorsPi‐Ling Chou (0000-0001-6316-1002, Kaohsiung Medical University), Pi-Ling Chou (Kaohsiung Medical University), Pei‐Chao Lin (0000-0002-1495-2550, Kaohsiung Medical University), Pei-Chao Lin (Kaohsiung Medical University), Chia‐Chin Lin (0000-0001-7658-8267, The University of Hong Kong, Hong Kong), Chia-Chin Lin (The University of Hong Kong, Hong Kong), Hsiang‐Chun Lee (0000-0002-5877-9059, Kaohsiung Medical University Chung-Ho Memorial Hospital), Hsiang-Chun Lee (Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan), Yu‐tung Huang (0000-0003-3224-7238, Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; Department of Health Care Management, College of Management, Chang Gung University, Taoyuan, Taiwan, corresponding author)
Year2024
Volume61
Pages469580241239143-469580241239143
Publication date2024-01-01
Open AccessYes
TypeARTICLE
VenueINQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL)
Journal identifiersISSN: 0046-9580 • E-ISSN: 1945-7243
PublisherSAGE Publishing (PUBLISHER • US)
DOI10.1177/00469580241239143
PMID38506439
OpenAlexW4393026280
LanguageEN
References cited39

A good death is a human right. Unfortunately, patients with chronic heart failure (CHF) in the terminal stage still receive inappropriate life-sustaining treatment before death. There is limited understanding of the status of intensive care unit (ICU) admission, mechanical ventilation (MV), cardiopulmonary resuscitation (CPR), and even extracorporeal membrane oxygenation (ECMO) for patients with CHF before death, as well as their use of hospice-related services. This study investigated the trends and trend changes in intensive procedures and hospice-related services for patients with CHF in the last month of life. This population-based retrospective observational study included 25 375 patients with CHF from the National Health Insurance research database in Taiwan and collected information on their intensive treatments during the last month of life. We computed intensive treatment utilization rates and analyzed the trends and trend changes via joinpoint regression. The average percentage of patients with CHF admitted to ICUs was 53.27% (n = 13 516). A total of 327 (1.29%) patients with CHF received ECMO. The percentages of patients receiving MV (54.3%'41.5%) and CPR (41.5%'17%) decreased over time. Conversely, the percentage of ECMO use (0.52%'1.78%) increased. However, only 222 (0.87%) patients with CHF received hospice care in the last month of life between 2001 and 2013. The rates of ICU admission and life-sustaining treatment among patients with CHF in the month before death remain high, and hospice-related services remain inadequate. This study highlights the need for research and training in providing palliative and hospice care for patients with CHF

Cardiopulmonary resuscitation · Extracorporeal membrane oxygenation · Heart failure · Intensive care · Intensive care medicine · Intensive care unit · Life support · Mechanical ventilation · Observational study · Palliative care · Population · Resuscitation · Retrospective cohort study · Emergency Medicine · Family and Patient Care in Intensive Care Units · Heart Failure Treatment and Management · Internal Medicine · Medicine · Nursing · Palliative Care and End-of-Life Issues

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