Trial reportCritical care medicine2019
Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial.
Trial report in Critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 68 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Preoperative Acceptance of Proactive Palliative Care Intervention
Impact of an Embedded Palliative Care and Hospice Practitioner in the Medical ICU
Evaluation of Burnout Syndrome Among Healthcare Professionals in Intensive Care Units Within the EPIC (Enhancing Palliative Care in ICU) Research
Who cites it
68 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.Intensive care medicine · 2024Guideline
- Needs-based triggers for timely referral to palliative care for older adults severely affected by noncancer conditions: a systematic review and narrative synthesis.BMC palliative care · 2023Pooled it
- Palliative care interventions in intensive care unit patients.Intensive care medicine · 2021Pooled it
- Advance Care Planning, Palliative Care, and End-of-life Care Interventions for Racial and Ethnic Underrepresented Groups: A Systematic Review.Journal of pain and symptom management · 2021Pooled it
- The effectiveness and cost-effectiveness of hospital-based specialist palliative care for adults with advanced illness and their caregivers.The Cochrane database of systematic reviews · 2020Pooled it
- Reduction in antimicrobial use among medical intensive care unit patients during a cluster randomized crossover trial of palliative care consultation.Infection control and hospital epidemiology · 2019Trial
- Decisions about palliative care and social determinants of health in intensive care units: a scoping review.Acute and critical care · 2026Article
- Early palliative care decision is associated with reduced end-of-life healthcare utilization in patients with esophageal and gastric cancer.Journal of gastrointestinal oncology · 2026Article
- Key characteristics of palliative care integration in intensive care units (ICUs): A scoping review.International journal of nursing studies advances · 2026Review
- Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026.Intensive care medicine · 2026Article
- CalShock: beyond the shock team, building on California's cardiogenic shock system of care.Heart failure reviews · 2026Article
- Minimizing hospital acquired intensive care unit infections: A focus on prevention.World journal of critical care medicine · 2026Review
- Embedding a Palliative Care Nurse Consultant Within a General Medicine Ward: A Prospective Exploratory Study.Journal of clinical nursing · 2026Article
- One voice at the bedside: aligning goals of care and prognostic communication in trauma and acute care surgery.Trauma surgery & acute care open · 2026Article
- A "PalliPulm" framework to improve palliative care education and practice in pulmonary-critical care medicine: an official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2026Article
- Mapping of key performance indicators for palliative care in intensive care settings: A scoping review protocol.HRB open research · 2026Article
- Article
- A machine learning model for predicting 28-day mortality in ICU patients with community-acquired pneumonia and acute kidney injury.Scientific reports · 2025Article
- Article
- [S1 guideline on sustainability in intensive care and emergency medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectivesTo assess the impact of early triggered palliative care consultation on the outcomes of high-risk ICU patients.
designSingle-center cluster randomized crossover trial.
settingTwo medical ICUs at Barnes Jewish Hospital. PATIENTS: Patients (n = 199) admitted to the medical ICUs from August 2017 to May 2018 with a positive palliative care screen indicating high risk for morbidity or mortality.
interventionsThe medical ICUs were randomized to intervention or usual care followed by washout and crossover, with independent assignment of patients to each ICU at admission. Intervention arm patients received a palliative care consultation from an interprofessional team led by board-certified palliative care providers within 48 hours of ICU admission. MEASUREMENTS AND MAIN
resultsNinety-seven patients (48.7%) were assigned to the intervention and 102 (51.3%) to usual care. Transition to do-not-resuscitate/do-not-intubate occurred earlier and significantly more often in the intervention group than the control group (50.5% vs 23.4%; p < 0.0001). The intervention group had significantly more transfers to hospice care (18.6% vs 4.9%; p < 0.01) with fewer ventilator days (median 4 vs 6 d; p < 0.05), tracheostomies performed (1% vs 7.8%; p < 0.05), and postdischarge emergency department visits and/or readmissions (17.3% vs 38.9%; p < 0.01). Although total operating cost was not significantly different, medical ICU (p < 0.01) and pharmacy (p < 0.05) operating costs were significantly lower in the intervention group. There was no significant difference in ICU length of stay (median 5 vs 5.5 d), hospital length of stay (median 10 vs 11 d), in-hospital mortality (22.6% vs 29.4%), or 30-day mortality between groups (35.1% vs 36.3%) (p > 0.05).
conclusionsEarly triggered palliative care consultation was associated with greater transition to do-not-resuscitate/do-not-intubate and to hospice care, as well as decreased ICU and post-ICU healthcare resource utilization. Our study suggests that routine palliative care consultation may positively impact the care of high risk, critically ill patients.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.