Evidence map›Paper›PMID 34363954›Full record

ArticleJournal of pain and symptom management2022

Advance Care Planning Documentation and Intensity of Care at the End of Life for Adults With Congestive Heart Failure, Chronic Kidney Disease, and Both Illnesses.

Gwen M Bernacki, Cara L McDermott, Daniel D Matlock, Ann M O'Hare, Lyndia Brumback, Nisha Bansal, James N Kirkpatrick, Ruth A Engelberg, Jared Randall Curtis

Open access · greenAbstract read
In one paragraph

Article in Journal of pain and symptom management, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 23% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Consensus document on palliative care in cardiorenal patients.Frontiers in cardiovascular medicine · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Gwen M BernackiCambia Palliative Care Center of Excellence, University of Washington (G.M.B., C.L.M., J.R.C.), Seattle, WA; Division of Cardiology, Department of Medicine, University of Washington (G.M.B., J.N.K.), Seattle, WA; Hospital and Specialty Medicine Service, VA Puget Sound Health Care System (G.M.B., A.M.H. ), Seattle, WA. Electronic address: bernacki@uw.edu.
Cara L McDermottCambia Palliative Care Center of Excellence, University of Washington (G.M.B., C.L.M., J.R.C.), Seattle, WA.
Daniel D MatlockDivision of Geriatrics, Department of Medicine, University of Colorado School of Medicine (D.D.M.), Aurora, CO; VA Eastern Colorado Geriatric Research Education and Clinical Center (D.D.M.), Denver, CO.
Ann M O'HareHospital and Specialty Medicine Service, VA Puget Sound Health Care System (G.M.B., A.M.H. ), Seattle, WA; Division of Nephrology, Department of Medicine, University of Washington (A.M.O., N.B.), Seattle; Kidney Research Institute, University of Washington (A.M.O., N.B.).
Lyndia BrumbackDepartment of Biostatistics, University of Washington (L.B.), Seattle.
Nisha BansalDivision of Nephrology, Department of Medicine, University of Washington (A.M.O., N.B.), Seattle; Kidney Research Institute, University of Washington (A.M.O., N.B.).
James N KirkpatrickDivision of Cardiology, Department of Medicine, University of Washington (G.M.B., J.N.K.), Seattle, WA; Department of Bioethics and Humanities, University of Washington (J.N.K., R.A.E.), Seattle, WA.
Ruth A EngelbergCambia Palliative Care Center of Excellence, University of Washington (G.M.B., C.L.M., J.R.C.), Seattle, WA; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington (R.A.E., J.R.C.), Seattle, WA; Department of Bioethics and Humanities, University of Washington (J.N.K., R.A.E.), Seattle, WA.
Jared Randall CurtisCambia Palliative Care Center of Excellence, University of Washington (G.M.B., C.L.M., J.R.C.), Seattle, WA; Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, University of Washington (R.A.E., J.R.C.), Seattle, WA.
University of Washington · USUniversity of Colorado Denver · USVA Puget Sound Health Care System · US

Funding

Refinement and Expansion of the Palliative Care Research Cooperative Group (PCRC)U24NR014637 · NINR · DUKE UNIVERSITY · PI KUTNER, JEAN S, POLLAK, KATHRYN I · 2013 to 2017
$9.6M
Palliative Care Research Cooperative Group (PCRC): Refinement and ExpansionU2CNR014637 · NINR · UNIVERSITY OF COLORADO DENVER · PI RITCHIE, CHRISTINE S · 2018 to 2022
$8.6M
Palliative Care Research Training GrantT32HL125195 · NHLBI · UNIVERSITY OF WASHINGTON · PI KROSS, ERIN KATHRYN, SHARMA, RASHMI K. · 2015 to 2024
$3.2M
University of Washington Implementation Science Training Program (UW-ISTP)K12K12HL137940 · NHLBI · UNIVERSITY OF WASHINGTON · PI AU, DAVID H, CURTIS, J RANDALL · 2017 to 2021
$2.9M
NHLBI NIH HHS K12 HL137940NHLBI NIH HHS T32 HL125195NINR NIH HHS U24 NR014637NINR NIH HHS U2C NR014637
6 · The paper itself

Abstract

contextHeart failure (HF) and chronic kidney disease (CKD) are associated with high morbidity and mortality, especially in combination, yet little is known about the impact of these conditions together on end-of-life care.

objectivesCompare end-of-life care and advance care planning (ACP) documentation among patients with both HF and CKD to those with either condition.

methodsWe conducted a retrospective analysis of deceased patients (2010-2017) with HF and CKD (n = 1673), HF without CKD (n = 2671), and CKD without HF (n = 1706), excluding patients with cancer or dementia. We compared hospitalizations and intensive care unit (ICU) admissions in the last 30 days of life, hospital deaths, and ACP documentation >30 days before death.

results39% of patients with HF and CKD were hospitalized and 33% were admitted to the ICU in the last 30 days vs. 30% and 28%, respectively, for HF, and 26% and 23% for CKD. Compared to patients with both conditions, those with only 1 were less likely to be admitted to the hospital [HF: adjusted odds ratio (aOR) 0.72, 95%CI 0.63-0.83; CKD: aOR 0.63, 95%CI 0.53-0.75] and ICU (HF: aOR 0.83, 95%CI 0.71-0.94; CKD: aOR 0.68, 95%CI 0.56-0.80) and less likely to have ACP documentation (aOR 0.53, 95%CI 0.47-0.61 and aOR 0.70, 95%CI 0.60-0.81).

conclusionsDecedents with both HF and CKD had more ACP documentation and received more intensive end-of-life care than those with only 1 condition. These findings suggest that patients with co-existing HF and CKD may benefit from interventions to ensure care received aligns with their goals.

Indexed as

Advance Care PlanningHeart FailureRenal Insufficiency, ChronicAdultDeathDocumentationHumansRetrospective StudiesAdvance care planningCardiorenal syndromeChronic kidney diseaseEnd-of-life care, Heart failureIntensity of care

Identifiers

PMID34363954
PMCPMC8814047
OpenAlexW3191188267

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

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.