SPICT as a predictive tool of mortality in Old Patients with Advanced Chronic diseases: a bicentric cohort study in Belgian Emergency departments
(2021) 17th Congress of the European Geriatric Medicine Society
Files
41999_2021_Article_585.pdf
Open Access - Adobe PDF
- 5.53 MB
Details
- Authors
- et. al.
- Abstract
- Introduction: Emergency clinicians are increasingly encountering older people suffering from polymorbidities, including some advanced chronic diseases. The decision to pursuit invasive and uncomfortable life-prolonging treatments or to initiate a palliative care approach is a challenge in the emergency department (ED). The Supportive and Palliative Care Indicators Tool (SPICT) could support them to identify people at risk of deteriorating and dying and timely address palliative care needs, but was never tested in ED for older persons (OP, ≥75 years) suffering from chronic diseases. Method: A prospective cohort study of OP admitted in two ED in Belgium. SPICT variables were collected, along with socio-demographic, medical and functional data. Survival & palliative symptoms and functional status were followed at 12 months by phone. Main outcome measures are sensitivity, specificity and likelihoods ratio. Results: We included 352 patients. The one-year follow-up is still ongoing. Results at one-year follow-up are available for 158 of them (mean age 83 years old (±5.58), 44% male). SPICT was positive for 76 patients (on 158), indicating a palliative profile. At one-year follow-up, 33 patients died (21%). The SPICT sensitivity and specificity are respectively 0.76 (IC95%,0.58-0.89) and 0.59 (IC95%, 0.50-0.68). LR- is 0.41 (IC95%, 0.22- 0.76) and LR+ is 1.86 (1.39-2.47). Conclusion: The SPICT showed satisfying sensitivity and LR- to reach a maximum of OP at risk of dying within one-year, for whom clinician should reassessed the intensity of care during ED admission.
- Affiliations
Citations
Bourmorck D, & et al. (2021). SPICT as a predictive tool of mortality in Old Patients with Advanced Chronic diseases: a bicentric cohort study in Belgian Emergency departments. European Geriatric Medicine, 12(Suppl 1), 1-387. https://doi.org/10.1007/s41999-021-00585-2 (Original work published 2021)