Palliative profile, one-year mortality and quality of life in older inpatients according to Be-PICT: a multicenter prospective cohort study

• Published in: Acta clinica belgica (English ed. Online) 2023-02, Vol.78 (1), p.16-24
• Main Authors: De Brauwer, Isabelle, Henrard, Séverine, Baeyens, Hilde, Van Den Noortgate, Nele, De Saint-Hubert, Marie, Piers, Ruth
• Format: Article
• Language: English
• Subjects: 1-year mortality; advance care planning; Advance directives; Aged; Belgium - epidemiology; Cohort analysis; Cohort Studies; Female; Humans; Inpatients; Male; Mortality; older person; Palliative care; Palliative Care - methods; Prognosis; Prospective Studies; Quality of Life
• ISSN: 1784-3286; 2295-3337
• DOI: 10.1080/17843286.2022.2053812

A palliative care approach (PCA), including advanced care planning (ACP), should be considered for patients with limited life expectancy. The Belgian Palliative Care Indicators Tool (Be-PICT) has been released to help identify patients who may benefit from such approach. This study aimed at measuring 1-year mortality and describe the quality of life in older inpatients, according to baseline Be-PICT results. Prospective multicentre cohort study in older patients (≥ 75 years) admitted at geriatrics and cardiology wards of four Belgian hospitals. The palliative profile was defined as a positive Be-PICT.1, defined by the presence of its three criteria, i.e. a negative physician's answer to the surprise question 'would you be surprised if this patient dies in the 6-12 next months?', ≥ 1 poor health indicator and ≥ 1 life-limiting condition. Of the 379 patients (50% aged ≥85 years; 51% female), 52 (14%) presented a palliative profile and 83 (23%) died within 1 year. Be-PICT.1 showed the following characteristics to predict 1-year mortality: sensitivity 0.54, specificity 0.83, positive and negative predictive values 0.48 and 0.86, positive and negative likelihood ratios 3.22 and 0.55. The patients with a palliative profile were at higher mortality risk (hazard ratio 4.79 p