Clinical trial NCT06984471: Characteristics of Patients in the ICU With Palliative Care Consults in a Tertiary University Hospital
Official title: Characteristics of Patients in the ICU With Palliative Care Consults in a Tertiary University Hospital
Study type: OBSERVATIONAL
Overall status: ACTIVE_NOT_RECRUITING
Conditions: Palliative Care Referral
Keywords: Intensive Care Unit
Lead sponsor: University Hospital, Basel, Switzerland
Sponsor class: OTHER
First posted: 2025-05-22
Enrollment: 532
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: All consecutive adult patients (i.e. \>= 18 years of age) that received a palliative care consult in the same hospitalization as their ICU stay at the University Hospital Basel between 2019 and until the end of 2024. .

Brief summary: The aim of this retrospective observational single-center cohort study is to investigate the factors associated with palliative care (PC) referral, examine intensive care unit (ICU) involvement before, during, or after the referral, and evaluate patient outcomes such as mortality, hospital and ICU length of stay, discharge destination, functional status, symptom management, and the content of PC consultation reports.

Detailed description: Palliative care (PC) in the intensive care unit (ICU) can improve care for critically ill patients by supporting decision-making, managing symptoms, and planning for end-of-life care. Early referral to PC has been linked to more do-not-resuscitate and do-not-intubate decisions, fewer ICU procedures, and more transfers to hospice care. However, PC is still underused in many ICUs, partly because doctors often overestimate patient survival. Most referral guidelines are based on older patients or those with serious conditions, which may not apply to younger or potentially recovering patients.

Existing studies mostly focus on survival or length of stay, with limited information on symptoms, functional recovery, or patient comfort. Some research suggests that PC needs are often not well met in the ICU.

This retrospective single-center cohort study aims to better understand when and why ICU patients are referred to PC, how their care changes, and what outcomes follow. It will also examine symptom management, functional outcomes, and recommendations made by the PC team.

The results of this study may help improve the timing and use of PC in the ICU to better support patient needs.

Eligibility criteria: Inclusion Criteria:

* Adult patients (i.e., patients ≥18 years of age)
* Palliative care consult either before, during or after a ICU stay at the University Hospital Basel between 2019 and until the end of 2024

Exclusion Criteria:

* Patients younger than 18 years
* Patients with documented refusal to use data

Primary outcomes:
measure: Patient demographics
timeFrame: 2019-2024
measure: Acute prehospital management data
timeFrame: 2019-2024
measure: Duration of intensive care unit stay
timeFrame: 2019-2024
measure: Duration of hospital stay
timeFrame: 2019-2024
measure: Discharge destination
timeFrame: 2019-2024
measure: Date of palliative care consult
timeFrame: 2019-2024
measure: Reason for palliative care consult
timeFrame: 2019-2024
measure: Place of palliative care consult
timeFrame: 2019-2024
measure: Number of visits by the palliative care team
timeFrame: 2019-2024
measure: Additional features of the palliative care consult
timeFrame: 2019-2024
measure: Comprehensive assessment of the neurological status based on validated clinical assessment
timeFrame: 2019-2024
measure: Comprehensive assessment of critical illness severity based on standardized scoring systems
timeFrame: 2019-2024
measure: Charlson Comorbidity Index
timeFrame: 2019-2024
measure: Laboratory parameters
timeFrame: 2019-2024
measure: Complications associated with palliative Care consult
timeFrame: 2019-2024
measure: Glasgow Outcome Score
timeFrame: 2019-2024
measure: Therapeutic intervention
timeFrame: 2019-2024
measure: Vital signs
timeFrame: 2019-2024
measure: Fluid balance data
timeFrame: 2019-2024
measure: Assessment of diagnostic procedure
timeFrame: 2019-2024
Secondary outcomes:
Other outcomes:
Locations:
city: Basel
country: Switzerland
facility: University Hospital Basel, Clinic for Intensive Care Medicine
Study officials:
affiliation: University Hospital Basel, Clinic for Intensive Care Medicine
name: Raoul Sutter, Prof. Dr. med.
role: PRINCIPAL_INVESTIGATOR
References: