Impact of Palliative Care on Resource Utilization and Quality in the Care of Patients Undergoing Therapeutic Hypothermia.

Few studies have been done assessing the impact of palliative care on patients suffering cardiac arrest and requiring therapeutic hypothermia (TH). We conducted a retrospective cohort study to compare resource utilization and quality indicators among patients undergoing TH with and without palliative care consultation. Data were collected, over a two-year period, from the institutional international cardiac arrest registry database and electronic medical record review. One hundred twenty-nine patients were screened, 102 met inclusion criteria. Sixty-four patients (63%) had a palliative care consult. None of the differences between the groups' prehospital clinical characteristics were significant (functional status p = 0.29; cerebral performance (CPC) score p = 0.16). The overall mortality rate of participants was 53%, with a rate of 47% for the nonpalliative care group and 56% of the palliative care group (p = 0.38). There was a decrease in resource utilization in the palliative care group, with discontinuation in lab tests showing significance (p = 0.04). All quality indicators were addressed more frequently in the palliative care group (p = < 0.0001). More patients in the palliative care group (56%) than in the nonpalliative care group (39%) had a do not resuscitate order placed (p = 0.10). Our results show reduced resource utilization and improved quality of care in patients undergoing TH treatment when palliative care is involved. These findings suggest that palliative care should be an integral part of the treatment guidelines for this patient population.