End-of-Life Patient Identification Assistance in Acute GEriatric Medicine

Study Overview
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Brief Summary
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The main objective of this project is to build a tool, adapted to the French geriatric population, that will predict the risk of death at three months after hospitalization in acute geriatric medicine. This tool will be built using selected items via a review of the literature published in 2015. The 8 items of the CriSTAL tool will be collected prospectively in all patients hospitalized successively in the 2 post-emergency geriatric services (PUG) of the University Hospital of Toulouse, over a period of 9 months, by a dedicated clinical research associate. Patient survival will be assessed by obtaining the vital status of the cohort via CépiDC

Detailed Description
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As the population ages, the prevalence of chronic diseases increases. Let's take the example of cardiovascular, respiratory or neurological diseases, including Alzheimer's disease. These pathologies are at the origin of decompensations requiring sometimes multiple hospitalizations. It is clear that the goals of care (curative or palliative) are not always related to life expectancy. Decision making, especially in an acute context, is often tricky. The use of a tool with certain parameters of the patient could help to guide the reflection. The present study propose a tool proposed by an Australian team (CriSTAL), which lists items described in the literature as a risk factor for the death of elderly patients. This tool is currently being studied in several types of populations around the world (general population, cancer patients, hospitalized etc.). This is a prospective study aimed at evaluating routine, single-center care, conducted at Toulouse University Hospital. The successive inclusion of hospitalized patients in Post Emergencies Geriatric (PUG) unity will be carried out over a period of 9 months. The primary outcome will be the vital status (alive / deceased) at 3 months of hospitalization in acute geriatric medicine.

Official Title
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End-of-Life Patient Identification Assistance in Acute GEriatric Medicine: Construction and Validation of a Prognostic Tool

Conditions
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Old Age

Intervention / Treatment
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* Other: Criteria for Screening and Triaging to Appropriate aLternative care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any geriatric patient hospitalized via emergencies at Post Emergencies Geriatric (PUG) unity Oral agreement of non-opposition to the use of the data relative to their hospitalization and relative to their evolution within 3 months following the hospitalization Exclusion Criteria: Patient having expressed his opposition to the use of data related to his hospitalization

Ages Eligible for Study
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Minimum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Criteria for Screening and Triaging to Appropriate aLternative care|CriSTAL Tool (Criteria for Screening and Treatment of Appropriate Long-Term Care) is a multidimensional geriatric tool that lists 18 elements of the literature, under construction and validation by an Australian retrospective study. This tool is a practical questionnaire and easy to use in current care, with items adapted to the geriatric dimension. The investigators chose to target hospitalized geriatric patients through emergencies.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The vital status (alive / deceased) at 3 months | The vital status (alive / deceased) at 3 months of hospitalization in acute geriatric medicine.Survival will be collected in a data base. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The 8 items of the CriSTAL tool | Socio-demographic data of the geriatric patient in the emergencies | 3 months | 
| The 8 items of the CriSTAL tool | The reason for admission of geriatric patients in the emergencies | 3 months | 
| The 8 items of the CriSTAL tool | The variables potentially associated with the three-month death like Cognitive impairment | 3 months | 
| The 8 items of the CriSTAL tool | The variables potentially associated with the three-month death : Hospitalization in intensive care during the last year | 3 months | 
| The 8 items of the CriSTAL tool | ECG anomaly : ACFA, tachycardia, rhythm disorder> 5 per min, Q or ST segment abnormality | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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End of life, Spotting, Emergency, criSTAL