Table 2.

Sample of Intensive Care Unit-Based Palliative Care Studies for Older Adult (Age ≥65 Years) Populations

Study	Study objective	Study setting	Sample	Mean age (years)	Study design	Finding
Carlson et al.48	Transition of patient care from ICU team to comprehensive support care team	MICU	n = 93; Patient is deemed hopelessly ill by ICU team, with common diagnoses, including severe neurologic injury, post-CPR anoxic encephalopathy, or end-stage malignancy	67	Before and after single-center trial	Reduced hospital LOS (33 to 10 days; p < 0.05); Reduced hospital charges ($36.2K to $13.2K; p < 0.05); No change in ICU LOS or mortality.
Schneiderman et al.50	Triggered ethics consult	Unspecified	n = 551; Patients for whom value-laden treatment conflicts were imminent or manifest	67.5	Prospective, multicenter, patient-randomized controlled trial	Among decedents: reduced ICU LOS (p = 0.03), hospital LOS (p = 0.01), ventilation days (p = 0.03); no change in mortality, artificial nutrition/hydration days.
Campbell and Guzman44	Triggered palliative care consultation	MICU	n = 81; Patients with terminal dementia admitted to an ICU	81	Before and after single-center trial	Reduced ICU and hospital LOS (6.8 to 3.5 days, 12.1 to 7.4 days; p < 0.004, p < 0.007, respectively); Fewer interventions for DNR patients (TISS 16.89 to 8.65; p < 0.01)
Lautrette et al.46	Family brochure, clinician education, and intensive communication with family using VALUE format to meetings	MICU, SICU, and mixed medical–surgical ICUs	n = 126; Patients who were deemed likely to die within a few days by the ICU attending physician	71	Prospective, multicenter, patient-randomized controlled trial	Reduced family member IES (p = 0.02), PTSD prevalence (69% to 45%; p = 0.01), and HADS score (p = 0.004); no change in ICU LOS or mortality.
Norton et al.47	Palliative care consultation	MICU	n = 191; Patients deemed as having a serious illness and at high risk of dying”	79	Before and after single- center trial	Reduced ICU LOS (16.3 to 9.0 days; p = 0.001); no change in hospital LOS or mortality.
Curtis et al. 2011106	Clinician education, local champions, feedback to clinicians, and order sets	MICU, SICU, and mixed medical-surgical ICUs	n = 2310; Targeted hospitals and ICU, not individual patients or patient populations	71	Prospective, multicenter, cluster-randomized controlled trial	Increased number of family conferences within 72 hours of admission and prognosis discussed during meeting (p < 0.001, p = 0.04, respectively); no change in family or nurse QODD, ICU LOS, or FS-ICU score.
Penrod et al.49	Family toolkit with family meeting pocket cards for ICU clinicians, family brochures, and ELNEC training and communication skills workshops for ICU nurses	Unspecified	n = 415; Targeted entire ICU, not individual patients or patient populations	70	Before and after multicenter trial	Increase in identification of surrogates (p < 0.05), family meetings convened within five days of admission (p < 0.05), meeting being interdisciplinary (p < 0.05); decrease in determination of advance directives (p < 0.01); no change in investigation of resuscitation status.

CPR, cardio pulmonary resuscitation; DNR, do-not-resuscitate order; ELNEC, End-of-Life Nursing Education Curriculum; FS-ICU, family satisfaction in the ICU; HADS, Hospital Anxiety and Depression Score; IES, Impact of Event Scale; LOS, length of stay; MICU, medical intensive care unit; PTSD, post-traumatic stress disorder; QODD, Quality of death and dying Score; SICU, surgical intensive care unit; TISS, Therapeutic Intervention Scoring System.