Evidence map›Paper›PMID 40274509›Full record

SynthesisBritish journal of anaesthesia2025

Palliative prognostic tools in surgical patients at the end of life: a systematic review.

Chuan-Whei Lee, Aaron B Wong, Smaro Lazarakis, Wen Kwang Lim, Jai Darvall

Abstract readSystematic Review
In one paragraph

Synthesis in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

5 authors.

Chuan-Whei LeeDepartment of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia. Electronic address: chuan-whei.lee@mh.org.au.
Aaron B WongParkville Integrated Palliative Care Service, Royal Melbourne Hospital and Peter MacCallum Cancer Hospital, Australia; Department of Aged Care, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Supportive and Palliative Care, Eastern Health, Melbourne, VIC, Australia; Department of Medicine, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.
Smaro LazarakisHealth Sciences Library, The Royal Melbourne Hospital, Melbourne Health, Melbourne, VIC, Australia.
Wen Kwang LimDepartment of Aged Care, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Medicine, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia.
Jai DarvallDepartment of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, VIC, Australia; Department of Critical Care, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia; Department of Intensive Care, The Royal Melbourne Hospital, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIdentifying surgical patients at the end of life (EOL) is the first step in integrating palliative and perioperative practices. Palliative prognostic tools (PPTs) are established frameworks from palliative care that assess patients at risk of early death. We conducted a systematic review investigating PPTs in adult surgical populations, their role in surgical decision-making, and their association with perioperative outcomes.

methodsA prospectively registered systematic review was performed (PROSPERO registration: CRD42023411303). Ovid MEDLINE, Ovid EMBASE, and Cochrane CENTRAL (Wiley) databases were searched for studies investigating PPTs in surgical patients. The primary outcome was the decision to proceed to surgery; secondary outcomes included mortality, quality of life, palliative care consultation, and EOL documentation completion. Abstract screening, full-text review, and study quality appraisal were performed by two authors independently. Results were synthesised narratively owing to study heterogeneity.

resultsSeven studies assessing four different PPTs were included in the review. Studies identified that 12-61% of surgical patients were at the EOL. Patients identified as being at the EOL by a PPT using an illness phase, trajectory approach, or both had an increased in-hospital and 12-month mortality. The impact on decisions to proceed to surgery was uncertain because of conflicting results. Palliative care referral and EOL document completion occurred in <15% of surgical patients at the EOL. No studies described patient-reported outcomes.

conclusionsPalliative prognostic tools have significant potential for incorporation into preoperative assessment. Future research should focus on preoperative end of life assessments and patient-reported outcomes such as quality of life, decision satisfaction, and disability-free survival.

Indexed as

Palliative CareSurgical Procedures, OperativeTerminal CareHumansPrognosisQuality of Lifeend of lifepalliative careprognostic toolserious illnesssurgery

Identifiers

PMID40274509
PMCPMC12106902

What OpenQuestion holds

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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.