@article{ref1,
title="The role of palliative care in acute trauma: when is it appropriate?",
journal="American journal of surgery",
year="2020",
author="Esquibel, Brendon M. and Waller, Christine J. and Borgert, Andrew J. and Kallies, Kara J. and Harter, Thomas D. and Cogbill, Thomas H.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: We hypothesized that trauma providers are reticent to consider palliative measures in acute trauma care.  METHODS: An electronic survey based on four patient scenarios with identical vital signs and serious blunt injuries, but differing ages and frailty scores was sent to WTA and EAST members.  RESULTS: 509 (24%) providers completed the survey. Providers supported early transition to comfort care in 85% old-frail, 53% old-fit, 77% young-frail, and 30% young-fit patients. Providers were more likely to transition frail vs. fit patients with (OR = 4.8 [3.8-6.3], p < 0.001) or without (OR = 16.7 [12.5-25.0], p < 0.001) an advanced directive (AD) and more likely to transition old vs. young patients with (OR = 2.0 [1.6-2.6], p < 0.001) or without (OR = 4.2 [2.8-5.0], p < 0.001) an AD.  CONCLUSIONS: In specific clinical situations, there was wide acceptance among trauma providers for the early institution of palliative measures. Provider decision-making was primarily based on patient frailty and age. ADs were helpful for fit or young patients. Provider demographics did not impact decision-making.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2020.10.002",
url="http://dx.doi.org/10.1016/j.amjsurg.2020.10.002"
}