A-qCPR risk score screening model for predicting 1-year mortality associated with hospice and palliative care in the emergency department.

Palliative Medicine
Ruei-Fang WangHsiu-Hsi Chen

Abstract

Evaluating the need for palliative care and predicting its mortality play important roles in the emergency department. We developed a screening model for predicting 1-year mortality. A retrospective cohort study was conducted to identify risk factors associated with 1-year mortality. Our risk scores based on these significant risk factors were then developed. Its predictive validity performance was evaluated using area under receiving operating characteristic analysis and leave-one-out cross-validation. Patients aged 15 years or older were enrolled from June 2015 to May 2016 in the emergency department. We identified five independent risk factors, each of which was assigned a number of points proportional to its estimated regression coefficient: age (0.05 points per year), qSOFA ⩾ 2 (1), Cancer (4), Eastern Cooperative Oncology Group Performance Status score ⩾ 2 (2), and Do-Not-Resuscitate status (3). The sensitivity, specificity, positive predictive value, and negative predictive value of our screening tool given the cutoff larger than 3 points were 0.99 (0.98-0.99), 0.31 (0.29-0.32), 0.26 (0.24-0.27), and 0.99 (0.98-1.00), respectively. Those with screening scores larger than 9 points corresponding to 64.0% (60.0-67.9%) of 1-...Continue Reading

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Software Mentioned

Supportive and Palliative Care Indicators tool ( SPICT )
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TWPCST
SPICT

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