The Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19.
Palliat Med
; 34(9): 1228-1234, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-653470
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) has a substantial mortality risk with increased rates in the elderly. We hypothesized that age is not sufficient, and that frailty measured by preadmission Palliative Performance Scale would be a predictor of outcomes. Improved ability to identify high-risk patients will improve clinicians' ability to provide appropriate palliative care, including engaging in shared decision-making about life-sustaining therapies.AIM:
To evaluate whether preadmission Palliative Performance Scale predicts mortality in hospitalized patients with COVID-19.DESIGN:
Retrospective observational cohort study of patients admitted with COVID-19. Palliative Performance Scale was calculated from the chart. Using logistic regression, Palliative Performance Scale was assessed as a predictor of mortality controlling for demographics, comorbidities, palliative care measures and socioeconomic status. SETTING/PARTICIPANTS:
Patients older than 18 years of age admitted with COVID-19 to a single urban public hospital in New Jersey, USA.RESULTS:
Of 443 admitted patients, we determined the Palliative Performance Scale score for 374. Overall mortality was 31% and 81% in intubated patients. In all, 36% (134) of patients had a low Palliative Performance Scale score. Compared with patients with a high score, patients with a low score were more likely to die, have do not intubate orders and be discharged to a facility. Palliative Performance Scale independently predicts mortality (odds ratio 2.89; 95% confidence interval 1.42-5.85).CONCLUSIONS:
Preadmission Palliative Performance Scale independently predicts mortality in patients hospitalized with COVID-19. Improved predictors of mortality can help clinicians caring for patients with COVID-19 to discuss prognosis and provide appropriate palliative care including decisions about life-sustaining therapy.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Palliative Care
/
Pneumonia, Viral
/
Prognosis
/
Frail Elderly
/
Hospital Mortality
/
Coronavirus Infections
/
Hospitalization
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
/
Young adult
Country/Region as subject:
North America
Language:
English
Journal:
Palliat Med
Journal subject:
Health Services
Year:
2020
Document Type:
Article
Affiliation country:
0269216320940566
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