Publications by authors named "Natalie T Kostelecky"
Assessment of Decision-Making Capacity in 97 Hospitalized Patients With Cancer: A Call for Standardization.
J Acad Consult Liaison Psychiatry
November 2024
Hospitalized patients with cancer face pivotal decisions that will affect their cancer care trajectory and quality of life, but frequently lack decision making capacity (DMC). Standardization is conspicuously missing for inpatient oncology teams and for consultation-liaison psychiatrists performing DMC assessments for patients with cancer. This study sought to characterize a single institutional experience of psychiatric consultations to assess DMC.
View Article and Find Full Text PDFBackground: Little is known on the effects of delirium onset and duration on outcome in critically ill patients with cancer.
Objectives: To determine the impact of delirium onset and duration on intensive care unit (ICU) and hospital mortality and length of stay (LOS) in patients with cancer.
Methods: Of the 915 ICU patients admitted in 2018, 371 were included for analysis after excluding for terminal disease, <24-h ICU stay, lack of active cancer and delirium.
Purpose: Although delirium is known to negatively affect critically ill patients, little data exist on delirium in critically ill patients with cancer.
Methods: We analyzed 915 critically ill patients with cancer between January and December 2018. Delirium screening was performed using the Confusion Assessment Method for the intensive care unit (ICU), performed twice daily.
Article Synopsis
- Patients with cancer who undergo cardiopulmonary resuscitation (CPR) have historically had low survival rates, but improvements in CPR outcomes and cancer survival mean that identifying those unlikely to survive can help guide important end-of-life discussions.
- A study of 854 cancer patients requiring CPR found that having indicators of a declining health trajectory significantly predicted poorer hospital outcomes, with only 5 out of 249 patients with decline indicators surviving to discharge.
- Those with indicators tended to be younger, have more advanced metastatic disease, and were more often treated in the ICU, while those without indicators had a higher rate of survival post-CPR and potential for further cancer intervention.