重症监护室（ICU）患者向姑息治疗（PC）病房的转换往往意味着建立姑息概念等变化。对于医务人员、患者和亲属来说，治疗目标的调整可能具有挑战性；然而，对这些转换轨迹的描述很少见。本回顾性研究的目的是通过描述轨迹和干预，对ICU向PC咨询团队及患者的咨询请求进行特征化分析。回顾分析了2019年在RWTH Aachen大学医院接受ICU治疗并请求过PC咨询的所有患者。将从ICU转到PC病房的患者群体与未转移的患者群体进行比较。每种情况下，对主要咨询进行评估，包括问题、警觉状态、从咨询请求到执行的时间长度以及主要问题的焦点。问题的焦点被分为“症状控制”、“咨询”和“转移”（打勾选项）。此外，还为进一步的备注提供了一个自由文本字段。通过访问电子病历来补充对诊断的探索。共评估了从ICU到PC病房的102次咨询请求。患者的发病率很高，大多数患者至少有以下一种诊断：肺部疾病（62%）、心血管疾病（61%）和/或神经系统疾病（55%）。转移到PC病房的患者中，无力感（94%）、疲劳（77%）、焦虑（55%）、疼痛（53%）和呼吸困难（48%）是最常见的症状。转移患者中的5人（16%）可以回家、疗养院、临终关怀机构或其他机构。总共，2019年在ICU接受姑息治疗专家观察的所有患者中，35人（34%）可以存活出院。不入院的最常见原因是PC病房容量不足（33%）、在等待名单上临终（20%）和患者拒绝（20%）。转到PC病房后，有7人（26%）在48小时内死亡。通过重症监护医师提出的咨询服务“症状控制”（χ2=10.17，p<0.05）和“咨询”（χ2=12.82，p<0.001），发现与姑息治疗团队实施的干预措施有显著关联。另一方面，对于从ICU到PC病房的患者的请求和实施的“转移”，没有找到显著的统计差异。比较转移到PC病房和未转移的患者群体时，观察到恶性肿瘤患者的转移频率显著增加（p=0.00）。ICU中对姑息治疗支持的需求超过了PC病房的入院能力。未来的研究应进一步探讨重症监护医学中的姑息治疗模式。© 2023年。作者。

The transition of patients from the intensive care unit (ICU) to the palliative care (PC) ward often implies changes including establishing a palliative concept. Adaptation of therapeutic goals can be challenging for medical staff, patients and relatives; however, descriptions of these transition trajectories are rare.The aim of this retrospective study was to characterize the consultation requests of the ICU to the PC consultation team as well as the patients by a description of trajectories and interventions.Retrospective analysis of all patients receiving intensive care at RWTH Aachen University Hospital in 2019 for whom a PC consultation was requested. The patient population transferred from the ICU to the PC ward was compared with the non-transferred population. In each case, the primary consultation was evaluated regarding the following factors: question, vigilance, length of time from consultation request to its performance, and primary focus of the question. The question focus was categorized into "symptom control", "counselling" and "transfer" (tick options). In addition, a free text field was available for further notes. Exploration of diagnoses was complemented by accessing the electronic health records.A total of 102 consultation requests from the ICU to the PC ward were evaluated. The morbidity of patients was high, and most patients had at least one of the following diagnoses: pulmonary (62%), cardiovascular (61%), and/or neurological disease (55%). Of the patients 32 (31%) were transferred to the PC ward, among whom weakness (94%), fatigue (77%), anxiety (55%), pain (53%), and dyspnea (48%) were the most frequently noted symptoms. Of the transferred patients 5 (16%) could be discharged to home, nursing home, hospice or other. In total, 35 (34%) of all patients who were seen by palliative care specialists on ICUs in 2019 could be discharged alive. The most frequent reasons for nonadmission were lack of capacity of the PC ward (33%), dying while being on the waiting list (20%), and refusal by the patient (20%). Of the patients, 7 (26%) died within 48 h after they had been transferred to the PC ward. Performed consultation services "symptom control" (χ2 = 10.17; p < 0.05) and "counselling" (χ2 = 12.82; p < 0.001), which were requested by the intensive care physicians, showed a significant linkage with the respective intervention performed by the palliative care team. On the other hand, no statistically significant difference was found for requested and performed "transfer" of patients from ICUs to PC ward. Comparing the transferred versus non-transferred patient population, a significantly more frequent transfer of patients with malignant tumors (p = 0.00) was observed.The need for palliative care support in the ICUs exceeded the admission capacity of the PC ward. Future studies should further examine palliative care models in intensive care medicine.© 2023. The Author(s).