How to estimate a senior's chance of dying within 30 days
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| Image via (AP Photo/Marco Vasini) |
A test devised by Sydney researchers to determine the likelihood of a patient's death within the next 30 days will be trialled in local hospitals from March.
The Criteria for Screening and Triaging to Appropriate aLternative care, or CriSTAL, developed by University of New South Wales researcher Magnolia Cardona-Morrel, would take into account 29 different criteria to assess whether it was worthwhile carrying out life-saving treatments and procedures.
The Criteria for Screening and Triaging to Appropriate aLternative care, or CriSTAL, developed by University of New South Wales researcher Magnolia Cardona-Morrel, would take into account 29 different criteria to assess whether it was worthwhile carrying out life-saving treatments and procedures.
Dr Cardona-Morrel said the test was designed to help doctors begin a conversation with terminally ill patients, particularly elderly patients, as to whether they would like to continue to receive treatment and where they would prefer to die.
"The test is easy to administer and the [answers] are readily available in the patient's clinical records and it can be completed in five or 10 minutes," she said. "The score by no means decides the treatment."
She said the aim of CriSTAL was to stop the common practice of terminally ill patients being put through unnecessary treatments and surgery in an attempt to save their lives.
"Doctors are keeping people alive because they can," Dr Cardona-Morrel said. "Hospitals are full of elderly people living longer because technology allows it. A lot of them would like to die at home."
Dr Cardona-Morrel said the results of the test were designed as a tool for doctors to use in discussing the available options with patients.
"When a patient is diagnosed with a terminal illness their first question is always, 'Doctor, how long do I have left?," she said.
"Doctors see their role as to protect their patients so they don't like to give them sad or bad news."
The test, which was presented at a medical conference in the US recently, has been welcomed by medical professionals around the world.
"I had lots of nurses and doctors standing there saying, 'We have been waiting for a tool like this for years, when can we start using it?'" she said.
"To me that is an indication there is a need out there."
She said once the score is determined the doctor could have a "transparent conversation" with the patient about their wishes and give them all the options available, including palliative care at home, or in a hospice.
The test is undergoing retrospective testing, looking at patients who have died and seeing if it would have been able to calculate the time they had left, before it is introduced into hospitals.
Dr Cardona-Morrel said the test was already being used in some Irish and US hospitals, and she hoped it would be in use in Australian hospitals by the end of the year.
Even though the test has not been designed for general practitioners to use, Dr Cardona-Morrel said she hoped it would encourage them to keep an eye out for the signs of a terminally ill patient and begin discussions about advanced care directives before the patient became too unwell.
The full list of criteria can be found in the paper by Dr Cardona-Morrell and Ken Hillman in the British Medical Journal.
"The test is easy to administer and the [answers] are readily available in the patient's clinical records and it can be completed in five or 10 minutes," she said. "The score by no means decides the treatment."
She said the aim of CriSTAL was to stop the common practice of terminally ill patients being put through unnecessary treatments and surgery in an attempt to save their lives.
"Doctors are keeping people alive because they can," Dr Cardona-Morrel said. "Hospitals are full of elderly people living longer because technology allows it. A lot of them would like to die at home."
Dr Cardona-Morrel said the results of the test were designed as a tool for doctors to use in discussing the available options with patients.
"When a patient is diagnosed with a terminal illness their first question is always, 'Doctor, how long do I have left?," she said.
"Doctors see their role as to protect their patients so they don't like to give them sad or bad news."
The test, which was presented at a medical conference in the US recently, has been welcomed by medical professionals around the world.
"I had lots of nurses and doctors standing there saying, 'We have been waiting for a tool like this for years, when can we start using it?'" she said.
"To me that is an indication there is a need out there."
She said once the score is determined the doctor could have a "transparent conversation" with the patient about their wishes and give them all the options available, including palliative care at home, or in a hospice.
The test is undergoing retrospective testing, looking at patients who have died and seeing if it would have been able to calculate the time they had left, before it is introduced into hospitals.
Dr Cardona-Morrel said the test was already being used in some Irish and US hospitals, and she hoped it would be in use in Australian hospitals by the end of the year.
Even though the test has not been designed for general practitioners to use, Dr Cardona-Morrel said she hoped it would encourage them to keep an eye out for the signs of a terminally ill patient and begin discussions about advanced care directives before the patient became too unwell.
The full list of criteria can be found in the paper by Dr Cardona-Morrell and Ken Hillman in the British Medical Journal.
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