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Best practice palliative care is delivered in parallel with life-sustaining or life-prolonging care. Palliative care affirms life and regards death as a normal process, intends neither to hasten death nor to postpone death and includes but is not limited to end-of-life care. Palliative care encompasses both primary palliative care (which can and should be incorporated into the practice of acute care surgery) and specialty palliative care (consultation with a fellowship-trained palliative care provider). Acute care surgeons routinely care for individuals who may benefit from palliative care. Patients exposed to traumatic injury, emergency surgical conditions, major burns and\/or critical surgical illness are more likely to be experiencing a serious illness than other hospitalized patients. Palliative care research is urgently needed in acute care surgery. At present, minimal high-quality research is available to guide selection of palliative care interventions. This narrative review summarizes the current state of research challenges and opportunities to address palliative care in acute care surgery. Palliative care research in acute care surgery can rely on either primary data collection or secondary and administrative data. Each approach has its advantages and limitations, which we will review in this article.<\/jats:p>","DOI":"10.1136\/tsaco-2024-001615","type":"journal-article","created":{"date-parts":[[2025,3,18]],"date-time":"2025-03-18T21:20:34Z","timestamp":1742332834000},"page":"e001615","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Palliative care in acute care surgery: research challenges and opportunities"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6488-7024","authenticated-orcid":false,"given":"Amelia W","family":"Maiga","sequence":"first","affiliation":[{"name":"Division of Acute Care Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Ho","sequence":"additional","affiliation":[{"name":"Division of Trauma, Critical Care, Emergency General Surgery, and Burns, Department of Surgery, MetroHealth, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1227-2420","authenticated-orcid":false,"given":"Rachel S","family":"Morris","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin, Milwaukee, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6433-9159","authenticated-orcid":false,"given":"Lisa M","family":"Kodadek","sequence":"additional","affiliation":[{"name":"Division of General Surgery, Trauma and Surgical Critical Care, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4150-5956","authenticated-orcid":false,"given":"Thaddeus J","family":"Puzio","sequence":"additional","affiliation":[{"name":"University of Texas Health Science Center at Houston, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4185-1739","authenticated-orcid":false,"given":"Gail T","family":"Tominaga","sequence":"additional","affiliation":[{"name":"Scripps Memorial Hospital La Jolla, La Jolla, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masami","family":"Tabata-Kelly","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zara","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Surgery and Public Health, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,18]]},"reference":[{"key":"2025082410412962000_10.1.e001615.1","unstructured":"ACS TQIP Palliative Care Best Practice Guidelines; 2017."},{"key":"2025082410412962000_10.1.e001615.2","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1001\/jamasurg.2022.4725","article-title":"All Surgeons Should Be Palliative Care Surgeons","volume":"157","author":"Katlic","year":"2022","journal-title":"JAMA Surg"},{"key":"2025082410412962000_10.1.e001615.3","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1016\/j.jpainsymman.2019.08.003","article-title":"Defining Serious Illness Among Adult Surgical Patients","volume":"58","author":"Lee","year":"2019","journal-title":"J Pain Symptom Manage"},{"key":"2025082410412962000_10.1.e001615.4","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1001\/jamasurg.2015.3625","article-title":"Palliative Care Interventions for Surgical Patients: A Systematic Review","volume":"151","author":"Lilley","year":"2016","journal-title":"JAMA Surg"},{"key":"2025082410412962000_10.1.e001615.5","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/SLA.0000000000002253","article-title":"Palliative Care in Surgery: Defining the Research Priorities","volume":"267","author":"Lilley","year":"2018","journal-title":"Ann Surg"},{"key":"2025082410412962000_10.1.e001615.6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/SLA.0000000000003894","article-title":"Improving Serious Illness Care for Surgical Patients: Quality Indicators for Surgical Palliative Care","volume":"275","author":"Lee","year":"2022","journal-title":"Ann Surg"},{"key":"2025082410412962000_10.1.e001615.7","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1177\/00031348221101597","article-title":"Palliative Care in the Trauma and Surgical Critical Care Settings: A Narrative Review","volume":"89","author":"Newsome","year":"2023","journal-title":"Am Surg"},{"key":"2025082410412962000_10.1.e001615.8","doi-asserted-by":"crossref","unstructured":"El-Qawaqzeh K , Magnotti LJ , Hosseinpour H , Nelson A , Spencer AL , Anand T , Bhogadi SK , Alizai Q , Ditillo M , Joseph B . 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