Impact of Palliative Care Team at a Cardiovascular Center on Treatment Strategies for Advanced Heart Failure

Background: Palliative care is recommended as a treatment strategy for advanced heart failure (HF): however, significance of team approach was unknown. We set up a palliative care team on May 2015 for palliation of total pain and support decision making (154 consultations during 2 years). In this study, we aimed to reveal the impact of the team for advanced HF. Methods: We retrospectively investigated consecutive 106 patients who admitted in our hospital and terminated in-hospital death for HF. We divided patients by the kick of point of the team (54 patients from May 2013 to April 2015, 52 patients from May 2015 to April 2017) and compared patients characteristics, usage of drugs, duration of intensive care unit (ICU) stay, location of death (ICU or general ward), and hospitalization cost between periods. Results: There were no significant differences in patients characteristics and hospitalization cost (1638740 ± 1459977 vs 1450922 ± 1395802 yen, P = .39). On the other hand, there were significant differences in usage of opioids (39 vs 71%, P = .0008), duration of ICU stay (7.1 ± 1.1 vs 3.6 ± 1.2 days, P = .017), location of death (ICU 24 vs 8%, P = .024). Conclusion: Palliative care team contributed to the usage of opioids and reduction of duration of stay and death at ICU. The results might be related to the recommendation of appropriate usage of drugs and earlier decision making support.