Determination of the characteristics and outcomes of the palliative care patients admitted to the emergency department

Bakan, Gülcan; Özen, Mert; Azak, Arife; Erdur, Bülent

doi:10.1016/j.ienj.2020.100934

Cited by 2 publications

(9 citation statements)

References 25 publications

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“…The 11 remaining studies each assessed a different screening tool 24,25,26,34‐41 and additional details are provided in Appendix 2. The majority of the screening tools consisted of a checklist of questions, such as the simplified screening tool (SST) included physicians completing two domains, the first of which consisting of an 11‐point scale assessing ambulation, activity, disease progression, self‐care, oral intake, and level of consciousness, as well as a checklist in which physicians identified at least one indicator of unmet PC needs 37 .…”

Section: Resultsmentioning

confidence: 99%

“…The quality of 22 studies were assessed using the NOS (see Appendix 5). 12,16,17,18,[20][21][22][23][24][25][26][30][31][32][33][34][35][36][38][39][40]46 The majority of these studies included a representative cohort of participants and sufficient follow-up. The majority of studies consisted of a single cohort, and studies with multiple groups did not report on controlling or adjusting for any potential differences among the groups.…”

Section: Risk-of-bias Assessmentmentioning

confidence: 99%

“…Alternatively, the median proportion of patients with unmet PC needs discharged from the ED was 23% (IQR 14%-28%). 12,16,19,20,23,25,29,38,39,45,46…”

Section: Dispositionmentioning

confidence: 99%

“…The timeline of when mortality was reported ranged from within hospital to over 30 days, 6 months, 8 months, or a 12-month period (see Table 3). The median proportion of patients who died in hospital was 12% (IQR 5%-25%), 12,16,17,18,19,25,27,32,39 while the median proportion of patients with unmet PC needs who died following discharge from the ED (ranging from 1 to 12 months) was 51% (IQR 25%-69%; see Table 3). 4,13,15,28,33,34,36,41,45 Subsequent health care utilization…”

Section: Mortalitymentioning

confidence: 99%

“…The 11 remaining studies each assessed a different screening tool 24,25,26,[34][35][36][37][38][39][40][41] and additional details are provided in Appendix 2.…”

Section: Other Screening Toolsmentioning

confidence: 99%

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Screening tools to identify patients with unmet palliative care needs in the emergency department: A systematic review

Kirkland

Yang

Clua

et al. 2022

Academic Emergency Medicine

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Objectives This systematic review identified and assessed psychometric properties of the available screening tools to identify patients with unmet palliative care (PC) needs in the emergency department (ED). Methods A comprehensive search of electronic databases and the gray literature was conducted. Two independent reviewers completed study screening and inclusion, data extraction, and quality assessment. A descriptive summary of the results was reported using median of medians and interquartile ranges (IQRs). Results A total of 35 studies were included, involving the assessment of 14 unique screening tools. The most commonly used screening tool was the surprise question (SQ; n = 12 studies), followed by the Palliative Care and Rapid Emergency Screening (P‐CaRES) tool (n = 8), and the screening for palliative and end‐of‐life care needs in the emergency department (SPEED) instrument (n = 4). Twelve of the included studies reported on the psychometric properties of the screening tools, of which eight of these studies assessed the performance of the SQ to predict patient mortality. Overall, the median sensitivity (63%, IQR 38%–78%) and specificity (75%, IQR 57%–84%) of the SQ to predict mortality at 1 or 12 months was moderate. While the median positive predictive value of the SQ was low (32%, IQR 16%–40%), the median negative predictive value was high (91%, IQR 88%–95%). Across the studies, the proportion of patients identified as having unmet PC based on the criteria of the screening tools ranged from 5% to 83%. Conclusions This review identified 14 unique screening tools used to identify adult patients with unmet PC needs in the ED. One screening tool, the SQ, was found to have moderate sensitivity and specificity to accurately predict future patient mortality. Additional research is needed to better understand the clinical value of this and the other available tools prior to their widespread implementation.

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Section: Resultsmentioning

confidence: 99%

Section: Risk-of-bias Assessmentmentioning

confidence: 99%

“…Alternatively, the median proportion of patients with unmet PC needs discharged from the ED was 23% (IQR 14%-28%). 12,16,19,20,23,25,29,38,39,45,46…”

Section: Dispositionmentioning

confidence: 99%

Section: Mortalitymentioning

confidence: 99%

“…The 11 remaining studies each assessed a different screening tool 24,25,26,[34][35][36][37][38][39][40][41] and additional details are provided in Appendix 2.…”

Section: Other Screening Toolsmentioning

confidence: 99%

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