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A Statistical Model for Early Recognition of Patients Requiring Transfer to Palliative Care (ERPAC)

Cihangir Dogu1,2,3, Ayse Muge Karcioglu, Isil Ozkocak Turan

  • 1Department of Critical Care, Ministry of Health Ankara City Hospital University, Cankaya, Ankara, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|March 22, 2023
PubMed

Insights

A new scoring system helps identify intensive care patients needing early palliative care. This tool aids in recognizing patients who will benefit from palliative care transfer, improving end-of-life planning.

Area of Science:

  • Medical Science
  • Critical Care Medicine
  • Palliative Care Research

Background:

  • Early identification of intensive care patients requiring palliative care is crucial for improving patient outcomes and resource allocation.
  • Existing methods may not adequately capture the complex needs of critically ill patients for palliative care referral.
  • Development of a validated scoring system is needed to facilitate timely palliative care integration.

Purpose of the Study:

  • To develop and validate a scoring system to identify intensive care patients who will require palliative care.
  • To establish a tool for early recognition of patients eligible for palliative care transfer.
  • To improve the integration of palliative care services within intensive care units.

Main Methods:

  • An analytical study was conducted in the General Intensive Care Unit at Ankara City Hospital.
  • Intensive care patients were categorized into palliative care transfer and non-transfer groups.
  • A scoring system, the Early Recognition of Palliative Care (ERPAC) score, was developed using logistic regression analysis based on factors like hospitalization duration, SOFAmax, previous hospitalization, and cancer history.

Main Results:

  • The study analyzed 135 intensive care patients, with 50.4% males, mean age 67.2 years.
  • Significant predictors for palliative care need included length of hospital stay (p<0.001), highest Sequential Organ Failure Assessment score (SOFAmax, p<0.001), previous hospitalization (p=0.015), and cancer history (p=0.009).
  • A predicted logit value > 0.5 indicated a patient's candidacy for palliative care transfer.

Conclusions:

  • The developed scoring system (ERPAC score) can effectively predict which intensive care patients will require palliative care.
  • This tool enables early identification of patients needing palliative care, facilitating timely intervention and support.
  • The ERPAC score can be calculated by individual intensive care units, promoting wider adoption and improved palliative care delivery.
Abstract

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