지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한응급의학회 Clinical and Experimental Emergency Medicine Clinical and Experimental Emergency Medicine Vol.6 No.1
- 발행연도
- 2019.1
- 수록면
- 70 - 76 (7page)
이용수
초록· 키워드
오류제보하기
Objective Few reliable and valid prognostic tools are available to help emergency physicians identify patients who might benefit from early palliative approaches. We sought to determine if responses to a modified version of the surprise question, “Would you be surprised if this patient died in the next 30 days” could predict in-hospital mortality and resource utilization for hospitalized emergency department patients. Methods For this observational study, emergency physicians responded to the modified surprise question with each admission over a five-month study period. Logistic regression analyses were completed and standard test characteristics evaluated. Results 6,122 visits were evaluated. Emergency physicians responded negatively to the modified surprise question in 918 (15.1%). Test characteristics for in-hospital mortality were: sensitivity 32%, specificity 85%, positive predictive value 6%, negative predictive value 98%. The risk of intensive care unit use (relative risk [RR], 1.87; 95% confidence interval [CI], 1.45 to 2.40), use of ‘comfort measures’ orders (RR, 3.43; 95% CI, 2.81 to 4.18), palliative-care consultation (RR, 3.06; 95% CI, 2.62 to 3.56), and in-hospital mortality (RR, 2.18; 95% CI, 1.72 to 2.76) were greater for patients with negative responses. Conclusion The modified surprise question is a simple trigger for palliative care needs, accurately identifying those at greater risk for in-hospital mortality and resource utilization. With a negative predictive value of 98%, affirmative responses to the modified surprise question provide reassurance that in-hospital death is unlikely.
목차
등록된 정보가 없습니다.
참고문헌 (15)
참고문헌 신청
Corita R. Grudzen / 2016 / Emergency Department–Initiated Palliative Care in Advanced Cancer / JAMA Oncology 2(5):591
Delgado-Guay MO / 2015 / Avoidable and unavoidable visits to the emergency department among patients with advanced cancer receiving outpatient palliative care / J Pain Symptom Manage 49:497~504
George N / 2016 / Palliative care screening and assessment in the emergency department: a systematic review / J Pain Symptom Manage 51:108~119
Wu FM / 2013 / Effects of initiating palliative care consultation in the emergency department on inpatient length of stay / J Palliat Med 16:1362~1367
Kistler EA / 2015 / Emergency department-triggered palliative care in advanced cancer: proof of concept / Acad Emerg Med 22:237~239
Delgado-Guay MO / 2015 / Avoidable and unavoidable visits to the emergency department among patients with advanced cancer receiving outpatient palliative care / J Pain Symptom Manage 49:497~504
George N / 2016 / Palliative care screening and assessment in the emergency department: a systematic review / J Pain Symptom Manage 51:108~119
Wu FM / 2013 / Effects of initiating palliative care consultation in the emergency department on inpatient length of stay / J Palliat Med 16:1362~1367
Kistler EA / 2015 / Emergency department-triggered palliative care in advanced cancer: proof of concept / Acad Emerg Med 22:237~239
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