The Association Between HIV Infection and the Use of Palliative Care in Patients Hospitalized With Heart Failure.
Shelli L Feder, Janet P Tate, Kathleen M Akgün and 8 others
PMID 30304939WHAT IT FOUND
Hospitalized veterans with heart failure and HIV were not more likely to receive palliative care unless HIV was advanced or uncontrolled.
Depression was linked to less palliative care.
Key findings
01HIV infection recorded by code was not linked to palliative care use.
02Patients with HIV as the primary hospital diagnosis, unsuppressed HIV-1 RNA, or CD4 counts below 200 cells/mm 3 were linked to palliative care use.
03Depression was linked to less palliative care use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was 99% male veterans, so results may not apply to women or non-veterans. The authors said the sample size was relatively small and the patients were younger than some other heart failure palliative care groups. Palliative care was identified by a billing code with reported sensitivity of 84% and specificity of 95%. The study could not control for unmeasured differences between groups. It did not examine AIDS-defining conditions or symptoms such as pain and fatigue.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that HIV infection alone automatically means palliative care is needed. HIV recorded by code was not associated with palliative care, and this observational study cannot show cause.