Screening for End-of-Life in Acute Hospitals: A Cross-Sectional Survey
Timothy To1,2,3, Paul Hakendorf3, David C Currow4,5
1Southern Adelaide Palliative Service, Flinders Medical Centre, Adelaide, AU-SA, Australia.
The American Journal of Hospice & Palliative Care
|January 10, 2024
Summary
Identifying high-risk patients in hospital using palliative care screening tools can improve advance care planning. The surprise question tool showed high accuracy in predicting mortality risk.
Area of Science:
- Palliative Care
- Geriatric Medicine
- Health Services Research
Background:
- Hospital admissions are common for patients nearing the end of life.
- Early identification of these patients allows for proactive future care planning.
Purpose of the Study:
- To evaluate the effectiveness of two screening tools in identifying hospital inpatients at high risk of mortality.
- To assess the utility of these tools for initiating advance care planning.
Main Methods:
- A cross-sectional survey was conducted on acute medical and surgical inpatients.
- The 'indicators for a palliative approach' and 'surprise question' screening tools were utilized.
Main Results:
- The overall one-year mortality was 27%.
- Patients identified by the 'indicators for a palliative approach' tool had a 52% mortality rate.
- Patients identified by the 'surprise question' tool had a 65% mortality rate, with an AUC of 0.84.
Conclusions:
- The 'indicators for a palliative approach' and 'surprise question' are effective screening tools.
- These tools can aid clinicians in identifying inpatients who would benefit from advance care planning.
- Implementing these tools can lead to a more tailored approach to patient care.
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