Outcomes of Heart Failure Patients on Palliative Inotrope Therapy in the Hospice Setting: A Single Center Retrospective Cohort Study.

Abstract

<b><i>Background:</i></b> Chronic intravenous inotropic support (CIIS) is recommended as palliative therapy for end-stage heart failure (HF) but is underutilized in hospice settings. <b><i>Objectives:</i></b> This study evaluates outcomes for patients on CIIS receiving hospice care. <b><i>Design:</i></b> Retrospective cohort study using electronic health records of patients on CIIS admitted to hospice. <b><i>Setting/Subjects:</i></b> Twenty-one patients admitted to a mid-Atlantic hospice between 2018 and 2022. <b><i>Measurements:</i></b> Data collected included demographics, inotropic therapy details, hospice length of stay (LOS), hospitalizations, and medication usage. <b><i>Results:</i></b> The mean age was 72.9 years; 67% were on milrinone. Patients had a mean hospice LOS of 49.6 days, with 66% experiencing no hospitalizations. Only 24% of patients required high-dose opioids. 24% of patients were discharged alive from hospice, and 52% died at home. <b><i>Conclusion:</i></b> Caring for patients on CIIS in hospice appears feasible and may portend some benefits to patients. Further research is warranted to confirm these findings in a prospective observational cohort.