We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Triggering palliative care referrals through the identification of poor prognosis in older patients presented to emergency departments in rural Australia.
- Authors
Pitman, Steven; Mason, Naomi; Cardona, Magnolia; Lewis, Ebony; O'Shea, Michael; Flood, Jacinta; Kirk, Mindy; Seymour, Jenny; Duncan, Anne
- Abstract
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.
- Subjects
AUSTRALIA; MORTALITY risk factors; WELL-being; TERMINAL care; HOSPITAL emergency services; CRITICALLY ill; PATIENTS; MEDICAL screening; INTERVIEWING; MEDICAL referrals; QUALITY of life; QUESTIONNAIRES; CHI-squared test; SENSITIVITY &; specificity (Statistics); STATISTICAL sampling; PALLIATIVE treatment; MEDICAL needs assessment; LONGITUDINAL method
- Publication
International Journal of Palliative Nursing, 2023, Vol 29, Issue 2, p83
- ISSN
1357-6321
- Publication type
Article
- DOI
10.12968/ijpn.2023.29.2.83