Integrating the Surprise Question, Palliative Care Screening Tool, and Clinical Risk Models to Identify Peritoneal...

Area of Science:

• Nephrology
• Palliative Care
• Medical Screening

Background:

• Universal screening can identify vulnerable patients needing palliative care in dialysis populations.
• Predicting mortality in peritoneal dialysis (PD) patients is crucial for timely interventions.

Purpose of the Study:

• To develop prediction models for one-year mortality in PD patients.
• To evaluate the effectiveness of screening tools in identifying high-risk PD patients.

Main Methods:

• Prospective cohort study of 401 Taiwanese PD patients.
• Utilized the surprise question (SQ) and palliative care screening tool (PCST).
• Developed multivariate logistic regression models and an integrated clinical risk model.

Main Results:

• The surprise question and PCST score of ≥4 predicted increased one-year mortality risk.
• An integrated model combining SQ, PCST, and clinical factors showed excellent discrimination (AUC 0.95).
• High-risk patients identified by the integrated model had significantly worse survival.

Conclusions:

• Integrated screening using SQ, PCST, and clinical risk factors effectively identifies high-risk PD patients.
• This approach can facilitate targeted palliative care interventions for at-risk subpopulations.
• Early identification of mortality risk in PD patients is essential for improving care.