Palliative Care Involvement in Patients with Operative Mortality After Cardiac Surgery


  • Hayden S. Leeds, BA Division of Cardiothoracic Surgery, Department of Surgery, Oregon Health and Science University, Portland, OR, USA
  • Danielle A. Smith, MD Cardiac Surgery Section, Operative Care Division, Portland Veterans Affairs Medical Center, Portland, OR, USA



cardiac surgery, palliative care, operative mortality


Background: The aim of this study was to examine palliative care involvement in patients with operative mortality after cardiac surgery, to gain a better understanding of this high-risk population and factors influencing referral.

Methods: This is a retrospective review using data submitted to the Society of Thoracic Surgeons National Database.

Results: The total study population included 93 patients with operative mortality, only 30% of whom had palliative care involvement. The median time from first palliative care involvement to death was 6 days. Nearly 40% of patients had a status labeled as elective at the time of surgery.

Conclusion: Our findings suggest that patient mortality risk for elective surgery is being underestimated, or the indications for palliative care consultation in high-risk patients is going unrecognized. Such knowledge may facilitate earlier palliative care involvement, with the goal of improved quality of life for cardiac patients.


Diop MS, Rudolph JL, Zimmerman KM, Richter MA, Skarf LM. Palliative care interventions for patients with heart failure: A systematic review and meta-analysis. J Palliat Med 2017;20:84-92.

Farjah F, Kaji AH, Chu D. Practical guide to surgical data sets: Society of Thoracic Surgeons (STS) National Database. JAMA Surg 2018;153:955-956.

Lilley EJ, Cooper Z, Schwarze ML, Mosenthal AC. Palliative care in surgery: Defining the research priorities. Ann Surg 2018;267:66-72.

Warraich HJ, Allen LA, Mukamal KJ, Ship A, Kociol RD. Accuracy of physician prognosis in heart failure and lung cancer: Comparison between physician estimates and model predicted survival. Palliat Med 2016;30:684-689.

Warraich HJH, Hernanedez AF, Allen, LA. How medicine has changed the end of life for patients with cardiovascular disease. J Am Coll Cardiol 2017;70:1276-1289.

Warraich HJ, Wolf SP, Mentz RJ, Rogers JG, Samsa G, Kamal AH. Characteristics and trends among patients with cardiovascular disease referred to palliative care. JAMA Netw Open 2019;2:e192375.



How to Cite

Leeds, H., & Smith, D. (2020). Palliative Care Involvement in Patients with Operative Mortality After Cardiac Surgery. The Heart Surgery Forum, 23(6), E789-E792.