Evidence map›Paper›PMID 39313780›Full record

ArticleBMC palliative care2024

Multicenter exploration of specialist palliative care in patients with left ventricular assist devices - a retrospective study.

Theresa Tenge, Shaylin Shahinzad, Stefan Meier, Manuela Schallenburger, Yann-Nicolas Batzler, Jacqueline Schwartz, Anja Coym, Johannes Rosenbruch, Mitra Tewes, Steffen T Simon and 6 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. 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

16 authors.

Theresa TengeDepartment of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany.
Shaylin ShahinzadInterdisciplinary Center for Palliative Medicine, Medical Faculty and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstrasse 5, Duesseldorf, 40225, Germany.
Stefan MeierDepartment of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany.
Manuela SchallenburgerInterdisciplinary Center for Palliative Medicine, Medical Faculty and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstrasse 5, Duesseldorf, 40225, Germany.
Yann-Nicolas BatzlerInterdisciplinary Center for Palliative Medicine, Medical Faculty and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstrasse 5, Duesseldorf, 40225, Germany.
Jacqueline SchwartzInterdisciplinary Center for Palliative Medicine, Medical Faculty and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Moorenstrasse 5, Duesseldorf, 40225, Germany. jacqueline.schwartz@med.uni-duesseldorf.de.
Anja CoymPalliative Care Unit, Department of Oncology, Hematology and Bone Marrow Transplant, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Johannes RosenbruchDepartment of Palliative Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
Mitra TewesDepartment of Palliative Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Steffen T SimonDepartment of Palliative Medicine and Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf CIO ABCD, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany.
Carmen RochInterdisciplinary Center for Palliative Medicine, University Hospital Wuerzburg, Würzburg, Germany.
Ute HibyRHÖN-Klinikum AG, Campus Bad Neustadt, Bad Neustadt an Der Saale, Germany.
Christian JungDepartment of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Udo BoekenDepartment of Cardiac Surgery, Medical Faculty and, University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.
Jan GaertnerPalliative Care Center Basel, Basel, Switzerland.
Martin NeukirchenDepartment of Anesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University Duesseldorf, Duesseldorf, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe number of advanced heart failure patients with left ventricular assist devices (LVAD) is increasing. Despite guideline-recommendations, little is known about specialist palliative care involvement in LVAD-patients, especially in Europe. This study aims to investigate timing and setting of specialist palliative care in LVAD-patients.

methodsWe conducted a retrospective multicenter study in 2022. Specialist palliative care services in German LVAD-centers were identified and invited to participate. Forty adult LVAD-patients (mean age 65 years (SD 7.9), 90% male) from seven centers that received a specialist palliative care consultation during hospitalization were included.

resultsIn 37 (67.3%) of the 55 LVAD-centers, specialist palliative care was available. The median duration between LVAD-implantation and first specialist palliative care contact was 17 months (IQR 6.3-50.3 months). Median duration between consultation and death was seven days (IQR 3-28 days). 65% of consults took place in an intensive/intermediate care unit with half of the patients having a Do-Not-Resuscitate order. Care planning significantly increased during involvement (advance directives before: n = 15, after: n = 19, p < 0.001; DNR before: n = 20, after: n = 28, p < 0.001). Symptom burden as assessed at first specialist palliative care contact was higher compared to the consultation requests (request: median 3 symptoms (IQR 3-6); first contact: median 9 (IQR 6-10); p < 0.001) with a focus on weakness, anxiety, overburdening of next-of-kin and dyspnea. More than 70% of patients died during index hospitalization, one third of these in a palliative care unit.

conclusionsThis largest European multicenter investigation of LVAD-patients receiving specialist palliative care shows a late integration and high physical and psychosocial symptom burden. This study highlights the urgent need for earlier integration to identify and address poorly controlled symptoms. Further studies and educational efforts are needed to close the gap between guideline-recommendations and the current status quo.

Indexed as

Heart-Assist DevicesPalliative CareAgedFemaleGermanyHeart FailureHumansMaleMiddle AgedRetrospective StudiesHeart-assist devicesHeart failureMulticenter studyPalliative medicineQuality of lifeRetrospective studies

Identifiers

PMID39313780
PMCPMC11421205

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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.