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Palliative profile, one-year mortality and quality of life in older inpatients according to Be-PICT : a multicenter prospective cohort study
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Background: A palliative care approach (PCA), including advanced care planning (ACP), should be considered for patients with limited life expectancy. The Belgian Palliative Care Indicators Tool (Be-PICT) has been released to help identify patients who may benefit from such approach. This study aimed at measuring 1-year mortality and describe the quality of life in older inpatients, according to baseline Be-PICT results.
Methods: Prospective multicentre cohort study in older patients (= 75 years) admitted at geriatrics and cardiology wards of four Belgian hospitals. The palliative profile was defined as a positive Be-PICT.1, defined by the presence of its three criteria, i.e. a negative physician’s answer to the surprise question ‘would you be surprised if this patient dies in the 6–12 next months?’, = 1 poor health indicator and = 1 life-limiting condition.
Results: Of the 379 patients (50% aged =85 years; 51% female), 52 (14%) presented a palliative profile and 83 (23%) died within 1 year. Be-PICT.1 showed the following characteristics to predict 1-year mortality: sensitivity 0.54, specificity 0.83, positive and negative predictive values 0.48 and 0.86, positive and negative likelihood ratios 3.22 and 0.55. The patients with a palliative profile were at higher mortality risk (hazard ratio 4.79 p < 0.001) and 1-year mortality rate (45%). Not using the SQ allowed to improve sensitivity to include a larger number of patients who may benefit from ACP and PCA.
Conclusions: Be-PICT.1 is a simple case-finding tool to identify older inpatients being at high mortality risk and candidates for ACP and PCA.
http://dx.doi.org/10.1080/17843286.2022.2053812
Voir la revue «Acta clinica Belgica»
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