Abstract
Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 894-898 |
| Number of pages | 5 |
| Journal | Journal of palliative medicine |
| Volume | 17 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2014 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Nursing(all)
- Anesthesiology and Pain Medicine
Cite this
Can hospices predict which patients will die within six months? / Harris, Pamela S.; Stalam, Tapati; Ache, Kevin A.; Harrold, Joan E.; Craig, Teresa; Teno, Joan; Smither, Eugenia; Dougherty, Meredith; Casarett, David.
In: Journal of palliative medicine, Vol. 17, No. 8, 01.08.2014, p. 894-898.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Can hospices predict which patients will die within six months?
AU - Harris, Pamela S.
AU - Stalam, Tapati
AU - Ache, Kevin A.
AU - Harrold, Joan E.
AU - Craig, Teresa
AU - Teno, Joan
AU - Smither, Eugenia
AU - Dougherty, Meredith
AU - Casarett, David
PY - 2014/8/1
Y1 - 2014/8/1
N2 - Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.
AB - Objective: To determine whether it is possible to predict, at the time of hospice enrollment, which patients will die within 6 months. Design: Electronic health record-based retrospective cohort study. Setting: Patients admitted to 10 hospices in the CHOICE network (Coalition of Hospices Organized to Investigate Comparative Effectiveness). Participants: Hospice patients. Main outcome measures: Mortality at 6 months following hospice admission. Results: Among 126,620 patients admitted to 10 hospices, 118,532 (93.6%) died within 6 months. In a multivariable logistic regression model, five characteristics were independent predictors of 6-month mortality. For instance, patients younger than 65 years were less likely to die within 6 months (odds ratio [OR] 0.64; 95% confidence interval [CI] 0.45-0.91; p=0.014). Conversely, male patients were more likely to die within 6 months (OR 1.47; 95% CI 1.05-2.02; p=;0.036). After adjusting for other variables in this model, there were several subgroups with a low probability of 6-month probability (e.g., stroke and Palliative Performance Scale [PPS] score=50; adjusted probability of 6-month mortality=39.4%; 95% CI: 13.9%-72.5%). However, 95% confidence intervals of these 6-month mortality predictions extended above 50%. Conclusions: Hospices might use several variables to identify patients with a relatively low risk for 6-month mortality and who therefore may become ineligible to continue hospice services if they fail to show significant disease progression.
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U2 - 10.1089/jpm.2013.0631
DO - 10.1089/jpm.2013.0631
M3 - Article
VL - 17
SP - 894
EP - 898
JO - Journal of Palliative Medicine
JF - Journal of Palliative Medicine
SN - 1096-6218
IS - 8
ER -