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Ann Am Thorac Soc. 2016 Jan 19. [Epub ahead of print]

Palliative Care for Patients Dying in the ICU with Chronic Lung Disease Compared to Metastatic Cancer.

Brown CE, Engelberg RA, Nielsen EL, Curtis JR.

To assess differences in planning and delivery of end of life care to patients in intensive care with differing diagnosis, patients with interstitial lung disease (ILD), chronic obstructive pulmonary disease (COPD) and metastatic cancer who died in 15 intensive care units in the USA were identified and end of life decisions and outcomes in each group were explored. Patients with ILD and COPD were less likely to have documentation of discussion about prognosis and more likely to be for resuscitation at time of death compared to patients with cancer. Patients with COPD were more likely to have cardiopulmonary resuscitation attempted. Patients with ILD were less likely to have documentation of pain assessment in the last day of life. Patients with COPD and ILD had longer stays in the intensive care unit and those with COPD also had longer lengths of stay in hospital. Planning and delivery of end of life care to patients with chronic lung diseases in intensive care should be more proactive.

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