TY  - JOUR
PY  - 2020//
TI  - The role of palliative care in acute trauma: when is it appropriate?
JO  - American journal of surgery
A1  - Esquibel, Brendon M.
A1  - Waller, Christine J.
A1  - Borgert, Andrew J.
A1  - Kallies, Kara J.
A1  - Harter, Thomas D.
A1  - Cogbill, Thomas H.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2020.10.002
ID  - ref1
ER  -