End-of-Life Care for Cardiac Patients: The Need for Greater Integration with Palliative Care Teams. Case Series and Literature Review

Abstract

BACKGROUND

There is a high demand for Palliative Care (PC) in patients with cardiovascular diseases. Professionals from any specialty should be able to offer Palliative Care and seek help from these specialists when necessary.

OBJECTIVE

To assess cardiologists' (C) perception of the need for PC for their patients, whether this prompted a consultation with the PC team, and what care they provided for patients who died during hospitalization.

METHODS

Cases admitted in one day at a quaternary cardiology center were evaluated, selecting those that died during hospitalization. Demographic, clinical data, interventions carried out during hospitalization, and therapeutic support limitation (TSL) decisions were collected. Cardiologists were asked about the risk of death during hospitalization and the need for PC for their patients.

RESULTS

Cardiologists recognized that 82.35% of patients were in the terminal phase of life. They stated that 75.53% needed PC, but only requested a consultation with the palliative care specialist for 16% of these. 41.18% of patients received a TSL plan, 76.5% died in Intensive Care Units, and a significant number of interventions were observed.

CONCLUSION

Cardiologists acknowledged the need for Palliative Care for most patients, but discussed TSL for few and indicated potentially inadequate interventions. Even recognizing this need, they did not call upon the PC team.