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The Surprise Question in Older Hospitalized Patients: To Use or Not to Use?

Published:February 17, 2022DOI:https://doi.org/10.1016/j.jamda.2022.01.058
      Identifying patients in the palliative phase is challenging but important, as timely and proactive palliative care can improve quality of life.
      • Temel J.S.
      • Greer J.A.
      • Muzikansky A.
      • et al.
      Early palliative care for patients with metastatic non-small-cell lung cancer.
      One way of determining whether a patient is in the palliative phase is via the Surprise Question, a widely recommended single-item tool (Would I be surprised if this patient died in the next 12 months?). However, there is a distinct lack of studies into the performance of the Surprise Question in older hospitalized patients. Currently, relatively few frail older patients have the opportunity to discuss their end-of-life care with their physician, even though most would appreciate such a conversation.
      • Sharp T.
      • Moran E.
      • Kuhn I.
      • et al.
      Do the elderly have a voice? Advance care planning discussions with frail and older individuals: a systematic literature review and narrative synthesis.
      The primary aim of this study was to establish the predictive validity of the Surprise Question in older hospitalized patients. Its secondary aims were to assess whether the validity of the Surprise Question is different between physicians and nurses, between patients aged ≥80 and <80 years, or improves by combining answers and adding age.
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