Prognostic significance of the "surprise" question in cancer patients

Journal of Palliative Medicine
Alvin H MossJame Abraham

Abstract

Physicians consistently overestimate survival for patients with cancer. The "surprise" question--"Would I be surprised if this patient died in the next year?"--improves end-of-life care by identifying patients with a poor prognosis. It has not been previously studied in patients with cancer. To determine the efficacy of the surprise question in patients with cancer. Prospective cohort study. Academic cancer center. 853 consecutive patients with breast, lung, or colon cancer. Surprise question classification and patient status at 12 months, alive or dead, by surprise question response. Oncologists classified 826 of 853 prospective patients with cancer (97%) with 131 (16%) classified into the "No" group and 695 (84%) into the "Yes" group. In multivariate analysis, a "No" response identified patients with cancer who had a seven times greater hazard of death in the next year compared to patients in the "Yes" group (HR 7.787, p < 0.001). Single center study. The surprise question is a simple, feasible, and effective tool to identify patients with cancer who have a greatly increased risk of 1-year mortality.

References

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Citations

Sep 12, 2013·Journal of Palliative Medicine·Jennifer A BlechmanVyjeyanthi S Periyakoil
Feb 1, 2014·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Katharine L CheungManjula Kurella Tamura
Sep 22, 2011·Expert Review of Cardiovascular Therapy·Jessi Khangura, Sarah J Goodlin
Dec 3, 2015·BMC Palliative Care·Arianne Brinkman-StoppelenburgAgnes van der Heide
May 23, 2014·The Linacre Quarterly·Christian BruggerRita L Marker
Jun 23, 2015·Journal of Palliative Medicine·Roby A ThomasAlvin H Moss
Feb 28, 2015·Journal of Palliative Medicine·Grant SmithSusan D Block
May 3, 2015·Trends in Cardiovascular Medicine·Shannon M Dunlay, Jacob J Strand
Nov 2, 2016·Journal of Palliative Medicine·Elizabeth J LilleyZara Cooper
Mar 26, 2014·Palliative Medicine·Matteo MoroniUNKNOWN on behalf of the SUQ-P group
Jul 13, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Oreofe O OdejideGregory A Abel
Feb 22, 2017·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Andrei D JavierKhaled Abdel-Kader
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