Triggering palliative care referrals through the identification of poor prognosis in older patients presented to emergency departments in rural Australia

Article

PITMAN, Steven | MASON, Naomi | CARDONA, Magnolia | LEWIS, Ebony | O'SHEA, Michael | FLOOD, Jacinta | KIRK, Mindy | SEYMOUR, Jenny | DUNCAN, Anne

Background: Without objective screening for risk of death, the palliative care needs of older patients near the end of life may be unrecognised and unmet. Aim: This study aimed to estimate the usefulness of the Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) tool in determining older patients’ risk of death within 3-months after initial hospital admission. Methods: A prospective cohort study of 235 patients aged 70+ years, who presented to two rural emergency departments in two adjacent Australian states, was utilised. The ‘risk of death’ of each patient was screened with the CriSTAL prognostic tool. Their 3-month follow-up outcomes were assessed through telephone interviews and a clinical record review. Findings: A CriSTAL cut-off score of more than 7 yielded a sensitivity of 80.7% and specificity of 70.81% for a 3-month risk of death. Palliative care services were only used by 31% of the deceased in their last trimester of life. Conclusion: Prognostic tools provide a viable means of identifying individuals with a poor prognosis. Identification can trigger an earlier referral to palliative care, which will benefit the patient's wellbeing and quality of life.

https://www.magonlinelibrary.com/doi/full/10.12968/ijpn.2023.29.2.83

Voir la revue «International Journal of Palliative Nursing, 29»

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