Effect of Integration of Palliative Care and Critical Care in ICU of a Tertiary Health Care Centre

Abstract

Aim: To observe and study the effects of integration of palliative care with critical care in ICU of a tertiary health care centre. Material and Methods: A retrospective study was performed between January 2019 to December 2019 at JK Hospital & LN Medical College, Bhopal, M.P. Patients characteristics were analyzed and then we studied the effects of integration by triaging the patients according to ECOG-PS. Results: The mean age of patients admitted in ICU was 57 years with neurological cause(45.39%) i.e. acute stroke as primary reason for ICU admission (26.47%) along with mortality rate of 11.82% and most common cause of mortality as MODS(44%). It was found that that a major part of patients who are terminally ill admitting to the ICU needs palliative care rather than aggressive critical care. Moreover, it was observed that at terminal stage of life in terminally ill patients, families preferred a peaceful death at home than at a hospital.Conclusion: Mortality rate is seen higher in age group >65 years with more than one organ failure. In these patients palliative care dominates over curative care. Segregation of these patients for palliative care showed better utilization of scarce medical resources and enhanced treatment decision making for the patients who required curative care and avoidable less financial burden on patients resources and ensuring a good death for the patients who require palliative care at terminal stage of illness.