Table 2. Secondary Outcomes Among the Primary Analytic Sample (n = 24 065)a.
| Outcome | Unadjusted No. (%) | Unadjusted difference (95% CI), % | Adjusted odds ratio (95% CI)b | P value | |
|---|---|---|---|---|---|
| Default order (n = 10 313) | Usual care (n = 13 752) | ||||
| Hospice discharge | 700 (6.8) | 952 (6.9) | −0.13 (−0.78 to 0.51) | 1.30 (1.07 to 1.57) | .008 |
| DNR at dischargec | 1886/5098 (37.0) | 3200/10594 (30.2) | 6.80 (5.20 to 8.37) | 1.40 (1.21 to 1.63) | <.001 |
| ICU mortality | 274 (2.7) | 311 (2.3) | 0.40 (−0.02 to 0.79) | 0.96 (0.71 to 1.29) | .78 |
| In-hospital death | 487 (4.7) | 578 (4.2) | 0.53 (0.02 to 1.06) | 0.86 (0.68 to 1.08) | .19 |
| ICU transferd | 735/9571 (7.7) | 976/13119 (7.4) | 0.24 (−0.45 to 0.94) | 1.13 (0.94 to 1.36) | .19 |
| Readmissions within 30 de | 1869 (18.1) | 2706 (19.7) | −1.55 (−2.55 to −0.55) | 1.01 (0.91 to 1.13) | .82 |
| Mean (SD) | 0.2 (0.5) | 0.2 (0.5) | −0.14 (−0.026 to −0.002) | Rate ratio, 1.02 (0.93 to 1.12) | .67 |
| Palliative care consultation | 4528 (43.9) | 2283 (16.6) | 27.30 (26.16 to 28.45) | 1.63 (1.52 to 1.76) | <.001 |
| Receipt of cardiopulmonary resuscitation | 71 (0.7) | 106 (0.8) | −0.09 (−0.30 to 0.13) | 0.97 (0.56 to 1.68) | .90 |
| Receipt of mechanical ventilation | 321 (3.1) | 412 (3.0) | 0.11 (−0.32 to 0.56) | 0.96 (0.74 to 1.24) | .73 |
| Time to consult, mean (SD), df | 3.4 (2.6) | 4.6 (4.8) | −1.16 (−1.38 to −0.96) | Subdistribution hazard rate, 3.97 (2.29 to 6.86) | <.001 |
The primary analytic sample includes participants with length of stay ≥72 hours.
Estimates adjusted for time, hospital, age, sex, race, ethnicity, marital status, source of hospital admission, Agency for Healthcare Research and Quality Elixhauser Comorbidity Index, eligible diagnosis (kidney failure, COPD, or dementia), number of days between repeated eligible admissions, and intensive care unit (ICU) location at enrollment.
Code status data were not available at 3 hospitals (15 692 missing).
ICU transfer analyses excluded participants who were in an ICU for the entire encounter (1375 excluded).
Readmissions included inpatient admissions to participating hospitals and other Ascension hospitals; observation visits were excluded.
Time-to-consult analyses included participants with a completed palliative care consult (n = 6811), defined as the time from hospital admission to the first signed consult note.