It is feasible to flag 'near end-of-life' status in older patients from routine general practice data

Aust J Gen Pract. 2020 Nov;49(11):752-758. doi: 10.31128/AJGP-08-19-5033.

Abstract

Method: A retrospective chart review was used to assess the feasibility of identifying these indicators in the data (160,897 patients from 464 practices across Australia). Conditional logistic regression was used to assess the independent contribution of nEOL indicators in patients aged 75-84 and ≥85 years using a case-control design matching by practice.

Results: The strongest indicators for nEOL status were advanced malignancy, residential aged care, nutritional vulnerability, anaemia, cognitive impairment and heart failure. Other indicators included hospital attendance, pneumonia, decubitus ulcer, chronic obstructive pulmonary disease, antipsychotic prescription, male sex and stroke.

Discussion: Consideration of routinely collected patient data may suggest nEOL status and trigger advance care planning discussions.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Australia
  • Feasibility Studies
  • Female
  • General Practice / methods
  • Geriatrics / methods
  • Humans
  • Male
  • Prognosis
  • Retrospective Studies
  • Terminal Care / classification*
  • Terminal Care / methods
  • Terminal Care / trends
  • Unnecessary Procedures / adverse effects
  • Unnecessary Procedures / trends*