A practical tool to identify patients who may benefit from a palliative approach: The CARING criteria

被引:86
作者
Fischer, Stacy M.
Gozansky, Wendolyn S.
Sauaia, Angela
Min, Sung-Joon
Kutner, Jean S.
Kramer, Andrew
机构
[1] Univ Colorado, Hlth Sci Ctr, Div Hlth Care Policy & Res, Denver, CO 80206 USA
[2] Univ Colorado, Hlth Sci Ctr, Div Geriatr, Denver, CO 80206 USA
[3] Univ Colorado, Hlth Sci Ctr, Div Internal Med, Denver, CO 80206 USA
关键词
prognosis; palliative care; mortality;
D O I
10.1016/j.jpainsymman.2005.08.012
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Palliative care is often offered only late in the course of disease after curative measures have been exhausted. To provide timelier symptom management, advance care planning, and spiritual support, we propose a simple set of prognostic criteria that identifies persons near the end of life. In, this retrospective cohort. study of five prognostic indicators, the CARING criteria. (Cancer, Admissions >= 2, Residence in a nursing home, Intensive care unit admit with multiorgan failure, >= 2 Noncancer hospice Guidelines), logistic repression modeling demonstrated high sensitivity and specificity for mortality at 1 year (c statistic > 0.8). A simple set of clinically relevant criteria applied at the time of hospital admission can, identify seriously ill persons who have a high, likelihood of death in 1 year and therefore, may benefit the most from incorporating palliative measures into the plan of care.
引用
收藏
页码:285 / 292
页数:8
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