Trends In Utilization of Palliative Care In Acute Heart Failure Admissions

Introduction Congestive heart failure is a leading cause of readmissions in the United States. Although treatment has come a long away, palliative care (PC) is often not appropriately offered in advanced heart failure. The purpose of this study was to use a large database of national in-patient sample to find out the penetrance of PC in acute heart failure admissions. Methods Data from 2002 to 2017 was used for analysis. ICD-9-CM and ICD-10-CM were used for PC encounter identifications in patients admitted with acute heart failure. Chi-square test was used for categorical variables and t-test for continuous variables. Multivariable Regression analysis was done for predictors of PC encounters. A p-value of Results The use of palliative care was found to be low at 4.1%, although recent trends have shown an increase (from 0.4% in 2002 to 6.2% in 2017). Women (0.3% in 2002 to 6.5% in 2017) and Caucasians (0.6% in 2002 to 6.9% in 2017) had a higher proportion of PC encounters as compared to men (0.5% in 2002 to 5.9% in 2017) and other racial minorities (Figure). On multivariable analysis; increasing age (OR, 1.04[CI; 1.03-1.04], p Conclusion The penetrance of palliative care has increased in the United States over the years; however, it is still low as compared to other high-income countries. More studies are needed to address the barriers to PC in patients of acute heart failure.