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Utilization of Palliative Care Screening Tool to Early Identify Patients with COVID-19 Needing Palliative Care: A

Yung-Feng Yen1,2,3,4,5, Hsiao-Yun Hu2,4,5, Yi-Chang Chou4

  • 1Section of Infectious Diseases, Taipei City Hospital, Yangming Branch, Taipei 112, Taiwan.

International Journal of Environmental Research and Public Health
|February 15, 2022
PubMed

Insights

A validated palliative care screening tool (PCST) effectively identifies hospitalized coronavirus disease 2019 (COVID-19) patients needing palliative care. Patients with a PCST score of 4 or higher faced a doubled mortality risk, highlighting the need for early intervention.

Area of Science:

  • Palliative Care
  • Infectious Diseases
  • Public Health

Background:

  • Identifying patients with coronavirus disease 2019 (COVID-19) who require palliative care is challenging.
  • Systematic screening is needed to ensure timely access to palliative care services for critically ill patients.

Purpose of the Study:

  • To evaluate a palliative care screening tool (PCST) for identifying hospitalized COVID-19 patients needing palliative care.
  • To assess the association between PCST scores and mortality risk in COVID-19 patients.
  • To examine the implementation of advance care planning (ACP) and advance directives (AD) in this population.

Main Methods:

  • A prospective cohort study of 897 hospitalized COVID-19 patients was conducted.
  • The validated palliative care screening tool (PCST) was used to assess palliative care needs.
  • Advance care planning (ACP) and advance directives (AD) were offered to patients with a PCST score ≥ 4.

Main Results:

  • 6.1% of patients had a PCST score ≥ 4.
  • Patients with a PCST score ≥ 4 had a significantly higher mortality rate (56.4% vs. 8.9%) and increased mortality risk (adjusted HR = 2.08).
  • 15 patients completed advance directives after physician discussions.

Conclusions:

  • The PCST is effective in identifying COVID-19 patients who would benefit from palliative care.
  • Early identification and intervention, including ACP and AD promotion, are crucial for improving outcomes in hospitalized COVID-19 patients.
  • Implementing a comprehensive palliative care program is imperative for this high-risk population.

Keywords:
COVID-19advance care planningadvance directivepalliative care programpalliative care screening toolprospective study

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