1. Association of Functional Status and Symptom Severity Among Patients Who Received Palliative Care Consultations.
- Author
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Blum, Moritz, Zeng, Li, Chai, Emily, and Gelfman, Laura P.
- Subjects
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STATISTICAL models , *HEART diseases , *KIDNEY failure , *CROSS-sectional method , *PALLIATIVE treatment , *RESEARCH funding , *LOGISTIC regression analysis , *SEDENTARY lifestyles , *FUNCTIONAL assessment , *QUESTIONNAIRES , *FUNCTIONAL status , *SEVERITY of illness index , *SYMPTOMS , *RETROSPECTIVE studies , *ANXIETY , *AGITATION (Psychology) , *DESCRIPTIVE statistics , *MANN Whitney U Test , *CHI-squared test , *ODDS ratio , *NEUROLOGICAL disorders , *ANOREXIA nervosa , *ANALYSIS of variance , *SEPSIS , *LUNG diseases , *INTENSIVE care units , *DYSPNEA , *CONFIDENCE intervals , *DATA analysis software , *TUMORS , *DEMENTIA , *NAUSEA , *MENTAL depression , *CONSTIPATION , *NOSOLOGY , *COVID-19 , *LIVER failure , *TRANSIENT ischemic attack - Abstract
Background: The relationship between functional status and the severity of different symptoms in patients with serious illnesses has not been explored in detail. Methods: We retrospectively evaluated registry data of hospitalized patients who received inpatient palliative care consults at the Mount Sinai Health System between January 01, 2020, and December 31, 2022. The registry was approved by the local institutional review board. During the initial consult, palliative care clinicians administered the Australia-modified Karnofsky Performance Status (KPS) and the Edmonton Symptom Assessment System (ESAS). We extracted these measures and other variables of interest from electronic health records and billing data, and assessed the association of functional status and symptom severity for different symptoms using ordinal logistic regression models. Results: The study included 9800 patients who received a palliative care consult. When modeling the association of functional status and the severity of different symptoms, two distinct groups of symptoms emerged: Nausea, physical discomfort, anxiety, depression, and constipation were more prevalent and severe among patients with higher functional status. Conversely, drowsiness, inactivity, dyspnea, anorexia, and agitation were more prevalent and severe among patients with lower functional status. These findings remained statistically significant after adjusting for possible confounders. Conclusion: Among patients who received inpatient palliative care consults, lower functional status was associated with a higher symptom burden. Furthermore, symptom profiles differed between patients with reduced functional status and those with preserved functional status. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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