Evidence map›Paper›PMID 34059507›Full record

ArticleBMJ supportive & palliative care2021

Supportive and Palliative Care Indicators Tool prognostic value in older hospitalised patients: a prospective multicentre study.

Ruth Piers, Isabelle De Brauwer, Hilde Baeyens, Anja Velghe, Lineke Hens, Ellen Deschepper, Séverine Henrard, Michel De Pauw, Nele Van Den Noortgate, Marie De Saint-Hubert

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Article in BMJ supportive & palliative care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ruth PiersDepartment of Geriatric Medicine, University Hospital Ghent, Ghent, Belgium ruth.piers@uzgent.be.ORCID http://orcid.org/0000-0001-5261-220X
Isabelle De BrauwerDepartment of Geriatric Medicine, Cliniques universitaires Saint-Luc, Bruxelles, Belgium.
Hilde BaeyensDepartment of Geriatric Medicine, AZ Alma campus Eeklo, Eeklo, Belgium.
Anja VelgheDepartment of Geriatric Medicine, University Hospital Ghent, Ghent, Belgium.
Lineke HensDepartment of Cardiology, University Hospital Ghent, Ghent, Belgium.
Ellen DeschepperBiostatistics Unit, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
Séverine HenrardUCL Institute of Health and Society, Bruxelles, Belgium.
Michel De PauwDepartment of Internal Medicine and Pediatrics, Ghent University Faculty of Medicine and Health Sciences, Ghent, Belgium.
Nele Van Den NoortgateDepartment of Geriatric Medicine, University Hospital Ghent, Ghent, Belgium.
Marie De Saint-HubertDepartment of Geriatric Medicine, CHU UCL Namur, Yvoir, Namur, Belgium.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAn increasing number of older patients are hospitalised. Prognostic uncertainty causes hospital doctors to be reluctant to make the switch from cure to care. The Supportive and Palliative Care Indicators Tool (SPICT) has not been validated for prognostication in an older hospitalised population.

aimTo validate SPICT as a prognostic tool for risk of dying within one year in older hospitalised patients.

designProspective multicentre study. Premorbid SPICT and 1-year survival and survival time were assessed. SETTING/

participantsPatients 75 years and older admitted at acute geriatric (n=209) and cardiology units (CUs) (n=249) of four hospitals.

resultsIn total, 59.3% (124/209) was SPICT identified on acute geriatric vs 40.6% (101/249) on CUs (p<0.001). SPICT-identified patients in CUs reported more functional needs and more symptoms compared to SPICT non-identified patients. On acute geriatric units, SPICT-identified patients reported more functional needs only.The HR of dying was 2.9 (95% CI 1.1 to 8.7) in SPICT-identified versus non-identified after adjustment for hospital strata, age, gender and did not differ between units. One-year mortality was 24% and 22%, respectively, on acute geriatric versus CUs (p=0.488). Pooled average sensitivity, specificity and partial area under the curve differed significantly between acute geriatric and CUs (p<0.001), respectively, 0.82 (95%CI 0.66 to 0.91), 0.49 (95%CI 0.40 to 0.58) and 0.82 in geriatric vs 0.69 (95% CI 0.42 to 0.87), 0.66 (95% CI 0.55 to 0.77) and 0.65 in CUs.

conclusionsSPICT may be used as a tool to identify older hospitalised patients at risk of dying within 1 year and who may benefit from a palliative care approach including advance care planning. The prognostic accuracy of SPICT is better in older patients admitted at the acute geriatric versus the CU.

Indexed as

clinical assessmentclinical decisionsend of life careheart failurehospital careprognosis

Identifiers

PMID34059507
PMCPMC11672032

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.