Clinical trial NCT03549585: End-of-Life Patient Identification Assistance in Acute GEriatric Medicine
Official title: End-of-Life Patient Identification Assistance in Acute GEriatric Medicine: Construction and Validation of a Prognostic Tool
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Old Age
Keywords: End of life
Spotting
Emergency
criSTAL
Lead sponsor: University Hospital, Toulouse
Sponsor class: OTHER
First posted: 2018-06-08
Enrollment: 1500
Sex: ALL
Minimum age (years): 65
Standard ages: OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: All consecutive patients above 65 years old hospitalized in the 2 departments of PUG Toulouse of University Hospital will be included, over a period of 9 months.

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: The vital status (alive / deceased) at 3 months
timeFrame: 3 months
Secondary outcomes:
measure: The 8 items of the CriSTAL tool
timeFrame: 3 months
measure: The 8 items of the CriSTAL tool
timeFrame: 3 months
measure: The 8 items of the CriSTAL tool
timeFrame: 3 months
measure: The 8 items of the CriSTAL tool
timeFrame: 3 months
measure: The 8 items of the CriSTAL tool
timeFrame: 3 months
Other outcomes:
Locations:
city: Toulouse
country: France
facility: University Hospital Toulouse
Study officials:
affiliation: University Hospital, Toulouse
name: Fati Nourhashemi, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Steinmeyer Z, Piau A, Thomazeau J, Kai SHY, Nourhashemi F. Mortality in hospitalised older patients: the WHALES short-term predictive score. BMJ Support Palliat Care. 2021 Nov 25:bmjspcare-2021-003258. doi: 10.1136/bmjspcare-2021-003258. Online ahead of print.