Utilisation of goals of care discussions and palliative care prior to image-guided procedures near the end of life

• Published in: Clinical radiology 2022-05, Vol.77 (5), p.345-351
• Main Authors: Rockwell, H.D., Beeson, S.A., Keller, E.J., Harman, S.M., Newton, I.G., Kothary, N.
• Format: Article
• Language: English
• Subjects: Death; Humans; Palliative Care; Patient Care Planning; Referral and Consultation; Retrospective Studies
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/j.crad.2022.01.050

To characterise image-guided procedures performed near the end of life and the use of goals of care discussions (GOC) and palliative care consultation (PCC) prior to these procedures. Retrospective chart review of 3,714 consecutive inpatient procedures performed for 2,351 patients and 8,206 outpatient procedures performed for 5,225 patients within a suburban medical system. Data were collected on demographics, procedures performed, mortality, and use of GOC or PCC prior to the procedures. Procedures near the end of life were classified as emergent, elective, or palliative. Logistic regression was used to assess for demographic disparities in care. Nine percent of inpatients died within 30 days of their procedure, 57% of which were within the same hospitalisation. Of these patients, 59% had a documented GOC and 35% had a PCC. Similarly, 7% of outpatients died within 6 months of their procedure. A minority of these patients had a documented GOC (37%) or PCC (13%). There were few statistically significant demographic disparities in this care and the associated odds ratios were small. A wide array of image-guided procedures is performed near the end of life. GOC and PCC are underutilised prior to these procedures. Few demographic disparities exist in this care. •Palliative care and advance care planning are means of improving end-of-life care.•These services occur prior to a minority of image-guided procedures.•There were few demographic disparities in who received these services.•End-of-life care in radiology could be improved with greater use of these services.