+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Identification of hospital patients in need of palliative care--a predictive score

Identification of hospital patients in need of palliative care--a predictive score

Bmc Palliative Care 15: 21

Palliative care was initially developed for patients with advanced cancer. Over the past years, however, palliative care has broadened its focus from terminal cancer patients to patients with other serious, life-limiting illnesses. Nevertheless, the identification of palliative care needs (PCNs) among hospital patients remains an insufficiently investigated topic of research. The aim of our study was to describe the characteristics of hospital patients with palliative care needs and to develop a score for their identification. We conducted an epidemiological study. Data were collected prospectively from inpatients at the University Medical Center Freiburg, Germany. For each patient discharged from a hospital ward, the treating physician had to report whether the patient had PCNs or not. The response rate was 96%, and data from 39,849 patients could be analyzed. A binary logistic regression analysis was performed in order to identify risk factors for developing PCNs and to develop a predictive score for the identification of patients with PCNs upon their admission to the hospital. In order to validate the risk prediction model, we used a bootstrap analysis. During the study period, 6.9% (2757) of all patients had palliative care needs. Only 56 of them (2%) received palliative treatment. Binary logistic regression analysis showed that older patients without relatives who suffered from metastatic cancer and/or liver cirrhosis had the highest risk of developing palliative care needs (PCN-score; sensitivity: 0.815; specificity: 0.640). Given the aging population and associated increase in the number of patients requiring palliative care, it is crucial to detect palliative care needs in hospital patients with both cancerous and non-cancerous life-limiting diseases. Our predictive score contributes to the identification of palliative care needs in patients with life-limiting diseases, which allows physicians to take the appropriate therapeutic steps.

(PDF emailed within 0-6 h: $19.90)

Accession: 058039562

Download citation: RISBibTeXText

PMID: 26906043

DOI: 10.1186/s12904-016-0094-7

Related references

Validation of the palliative prognostic index and palliative prognostic score in a palliative care consultation team setting for patients with advanced cancers in an acute care hospital in Japan. American Journal of Hospice and Palliative Care 31(7): 730-734, 2016

Evaluation of the Palliative Prognostic Score (PaP) and routinely collected clinical data in prognostication of survival for patients referred to a palliative care consultation service in an acute care hospital. Journal of Pain and Symptom Management 42(3): 419-431, 2011

Survival prediction for advanced cancer patients in the real world: A comparison of the Palliative Prognostic Score, Delirium-Palliative Prognostic Score, Palliative Prognostic Index and modified Prognosis in Palliative Care Study predictor model. European Journal of Cancer 51(12): 1618-1629, 2015

Successful validation of the palliative prognostic score in terminally ill cancer patients. Italian Multicenter Study Group on Palliative Care. Journal of Pain and Symptom Management 17(4): 240-247, 1999

A new palliative prognostic score: a first step for the staging of terminally ill cancer patients. Italian Multicenter and Study Group on Palliative Care. Journal of Pain and Symptom Management 17(4): 231-239, 1999

Identifying patients in need of a palliative care assessment in the hospital setting: a consensus report from the Center to Advance Palliative Care. Journal of Palliative Medicine 14(1): 17-23, 2011

Palliative care in patients with primary cutaneous lymphoma: symptom burden and characteristics of hospital palliative care team input. Archives of Dermatology 143(3): 423-424, 2007

Predictive value of score parameters of the Simplified Acute Physiology Score (SAPS)-II for the duration of treatment of intensive care patients. Wiener Klinische Wochenschrift 108(15): 462-466, 1996

Early identification of palliative care patients in general practice: development of RADboud indicators for PAlliative Care Needs (RADPAC). British Journal of General Practice 62(602): E625-E631, 2013

What determines duration of palliative care before death for patients with advanced disease? A retrospective cohort study of community and hospital palliative care provision in a large UK city. Bmj Open 6(12): E012576, 2017

The university hospital palliative care team's approach to the transfer of end-stage cancer patients from hospital care to home medical care. Gan to Kagaku Ryoho. Cancer and ChemoTherapy 36 Suppl 1: 75-77, 2010

Palliative sedation in a specialized unit for acute palliative care in a cancer hospital: comparing patients dying with and without palliative sedation. Journal of Pain and Symptom Management 36(3): 228-234, 2008

Integrating Palliative Care Into the Care of Neurocritically Ill Patients: A Report From the Improving Palliative Care in the ICU Project Advisory Board and the Center to Advance Palliative Care. Critical Care Medicine 43(9): 1964-1977, 2015

Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study. Palliative Medicine 28(5): 403-411, 2015

Predictive factors for do-not-resuscitate designation among terminally ill cancer patients receiving care from a palliative care consultation service. Journal of Pain and Symptom Management 47(2): 271-282, 2015