{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T06:09:34Z","timestamp":1789711774871,"version":"4.0.1"},"reference-count":22,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Clinicians place comfort measures only (CMO) orders for hospitalized patients at the end-of-life when a decision has been made to focus on patient comfort and allow the natural dying process to occur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>Our primary aim was to assess the associations of specialty palliative consults (SPC) or documented goals of care conversations (GOCC) with in-hospital mortality among patients with CMO orders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>We completed a retrospective cross-sectional study of data from the electronic medical record.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>We assessed all adult patients with CMO orders admitted to four hospitals in the United States between 2022 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>We used descriptive statistics and multivariable logistic regression and linear regression models to identify the association of SPC and documented GOCC with patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 6789 hospitalized patients with CMO orders, 48% were female, and these patients had median age 71 years. Seventy-three percent died in-hospital, and 22% were discharged with hospice. SPC placed anytime during hospital admission were associated with lower in-hospital mortality (aOR 0.4, 95% CI 0.3\u20130.6,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001) and higher discharge with hospice (aOR 2.4, 95% CI 1.8\u20133.2,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). In contrast, documented GOCC anytime during admission were associated with higher in-hospital mortality (aOR 1.8, 95% CI 1.3\u20132.4,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0004) and lower discharge with hospice (aOR 0.5, 95% CI 0.4\u20130.7,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For patients with CMO orders, SPC, rather than documented GOCC, were associated with lower in-hospital mortality and higher receipt of hospice. Future research should explore reasons why only SPC, and not documented GOCC, were associated with these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261452339","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T08:55:56Z","timestamp":1780908956000},"page":"1367-1374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes for Hospitalized Patients with Comfort Measures Only Orders"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3958-4491","authenticated-orcid":false,"given":"Gina","family":"Piscitello","sequence":"first","affiliation":[{"name":"Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."},{"name":"Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Durant","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tami","family":"Minnier","sequence":"additional","affiliation":[{"name":"Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Haranis","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Schell","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Section of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."},{"name":"Palliative Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Joint Commission National Quality Measures. Specifications Manual for Joint Commission National Quality Measures (v2015A) - Comfort Measures Only [Internet]. Available from: https:\/\/manual.jointcommission.org\/releases\/TJC2015A\/DataElem0031.html [Last accessed: May27 2025]."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2022.06.014"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007610"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.01.014"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000114816.62331.08"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.19502"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2014.001429"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/CAT.22.0214"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2020.0636"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2023.07.015"},{"key":"e_1_3_2_12_2","unstructured":"America\u2019s Health Rankings analysis of National Hospice and Palliative Care Organization. NHPCO Facts and Figures Report Series [Internet] Available from: AmericasHealthRankings.org."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000000358"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2022.0460"},{"key":"e_1_3_2_15_2","unstructured":"ACGME. ACGME Program Requirements for Graduate Medical Education in Hospice and Palliative Medicine. 2022. Available from: https:\/\/www.acgme.org\/globalassets\/pfassets\/programrequirements\/540_hospicepalliativemedicine_2022.pdf"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/10499091211014160"},{"key":"e_1_3_2_17_2","unstructured":"CAPC. Conversation Script: Talking to Patients About Hospice [Internet]. Available from: https:\/\/www.capc.org\/conversation-script-talking-to-patients-about-hospice\/ [Last accessed: June9 2025]."},{"key":"e_1_3_2_18_2","unstructured":"3HC. How Long Does It Take to Admit A Patient to Hospice? [Internet]. 3HC. 2023. Available from: https:\/\/www.3hc.org\/blog\/how-long-does-take-to-admit-a-patient-to-hospice\/ [Last accessed: June9 2025]."},{"key":"e_1_3_2_19_2","unstructured":"Compassus. Preparing for At-Home Hospice Care [Internet]. Compassus. Available from: https:\/\/www.compassus.com\/for-caregivers\/frequently-asked-questions\/prepare-your-home-for-hospice\/ [Last accessed: June9 2025]."},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2023.08.014"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/1049909119843133"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.09.017"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.12.029"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261452339","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10966218261452339","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261452339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:44:32Z","timestamp":1789710272000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10966218261452339"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":22,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,1]]}},"alternative-id":["10.1177\/10966218261452339"],"URL":"https:\/\/doi.org\/10.1177\/10966218261452339","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]}}}