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

Old Age Clinical Trial

— ARPEGE  

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03549585
• Other study ID #: RC31/15/7732
• Secondary ID: 2016-A00116-45
• Status: Completed
• Start date: June 27, 2017
• Est. completion date: September 30, 2019

Study information

• Verified date: January 2022
• Source: University Hospital, Toulouse
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1500
• Est. completion date: September 30, 2019
• Est. primary completion date: September 30, 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 65 Years and older

Eligibility

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

Related Conditions & MeSH terms

• Death
• Old Age

Intervention

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.

Locations

Country	Name	City	State
France	University Hospital Toulouse	Toulouse

Sponsors (1)

Lead Sponsor	Collaborator
University Hospital, Toulouse

Country where clinical trial is conducted

France, 

References & Publications (1)

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. pii: bmjspcare-2021-003258. doi: 10.1136/bmjspcare-2021-003258. [Epub ahead — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	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	The 8 items of the CriSTAL tool	Socio-demographic data of the geriatric patient in the emergencies	3 months
Secondary	The 8 items of the CriSTAL tool	The reason for admission of geriatric patients in the emergencies	3 months
Secondary	The 8 items of the CriSTAL tool	The variables potentially associated with the three-month death like Cognitive impairment	3 months
Secondary	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
Secondary	The 8 items of the CriSTAL tool	ECG anomaly : ACFA, tachycardia, rhythm disorder> 5 per min, Q or ST segment abnormality	3 months