Efficacy of a tool to predict short-term mortality in older people presenting at emergency departments: Protocol for a multi-centre cohort study
| Autor: | Hanne Nygaard, Chan Wei Chang, Anna Holdgate, Luis Winoto, Sally McCarthy, Dorothy Breen, Anette Ekmann, Robin M. Turner, Michael O'Sullivan, Birgitte Nybo Jensen, Blanca Gallego-Luxan, Stephen Edward Asha, Ken Hillman, Rune Overgaard Jensen, Sam Suri, Christian Backer Mogensen, Helene Skjøt-Arkil, Magnolia Cardona, John Mackenzie, Hatem Alkhouri, Jonas L. Pedersen, Mikkel Brabrand, John Asger Petersen, Jonas Junghans Jensen, Ebony T. Lewis, Mette Rahbek Kristensen, Margaret Perkins |
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| Rok vydání: | 2018 |
| Předmět: |
Advance care planning
Male Aging medicine.medical_specialty Health (social science) Disease Emergency departments Clinical decision support system law.invention 03 medical and health sciences 0302 clinical medicine law Risk Factors medicine Humans 030212 general & internal medicine Prospective Studies Mortality Prospective cohort study Aged Aged 80 and over business.industry Uncertainty 030208 emergency & critical care medicine Clinical decision support Prognosis Intensive care unit Checklist Risk prediction Intensive Care Units Logistic Models Validation studies Emergency medicine Cohort Cohort studies Female Geriatrics and Gerontology business Emergency Service Hospital Gerontology Cohort study |
| Zdroj: | Cardona, M, Lewis, E T, Turner, R M, Alkhouri, H, Asha, S, Mackenzie, J, Perkins, M, Suri, S, Holdgate, A, Winoto, L, Chang, C-W, Gallego-Luxan, B, McCarthy, S, Kristensen, M R, O'Sullivan, M, Skjøt-Arkil, H, Ekmann, A A, Nygaard, H H, Jensen, J J, Jensen, R O, Pedersen, J L, Breen, D, Petersen, J A, Jensen, B N, Mogensen, C B, Hillman, K & Brabrand, M 2018, ' Efficacy of a tool to predict short-term mortality in older people presenting at emergency departments : Protocol for a multi-centre cohort study ', Archives of Gerontology and Geriatrics, vol. 76, pp. 169-174 . https://doi.org/10.1016/j.archger.2018.02.014 |
| ISSN: | 1872-6976 |
| DOI: | 10.1016/j.archger.2018.02.014 |
| Popis: | BACKGROUND: Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments.METHODS: Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland. Electronic and paper clinical records will be used to extract risk factors such as nursing home residency, physiological deterioration warranting a rapid response call, personal history of active chronic disease, history of hospitalisations or intensive care unit admission in the past year, evidence of proteinuria or ECG abnormalities, and evidence of frailty to be concurrently measured with Fried Score and Clinical Frailty Scale. Patients or their informal caregivers will be contacted by telephone around three months after initial assessment to ascertain survival, self-reported health, post-discharge frailty and health service utilisation since discharge. Logistic regression and bootstrapping techniques and AUROC curves will be used to test the predictive accuracy of CriSTAL for death within 90 days of admission and in-hospital death.DISCUSSION: The CriSTAL checklist is an objective and practical tool for use in emergency departments among older patients to determine individual probability of death in the short-term. Its validation in this cohort is expected to reduce clinicians' prognostic uncertainty on the time to patients' death and encourage timely end-of-life conversations to support clinical decisions with older frail patients and their families about their imminent or future care choices. |
| Databáze: | OpenAIRE |
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