End-of-Life Patient Identification Assistance in Acute GEriatric Medicine (ARPEGE)

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

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

Study Overview

• Status: Completed
• Conditions: Old Age
• Intervention / Treatment: Other: Criteria for Screening and Triaging to Appropriate aLternative care

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.

• Study Type: Observational
• Enrollment (Actual): 1500

Contacts and Locations

Study Locations

• France
  • Toulouse, France, 31052
    • University Hospital TOULOUSE

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 65 years and older (Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• 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.

Description

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

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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 Outcome Measures

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

Collaborators and Investigators

• Sponsor: University Hospital, Toulouse
• Investigators: Principal Investigator: Fati Nourhashemi, MD, University Hospital, Toulouse

Publications and helpful links

General Publications

• 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.

Study record dates

Study Major Dates

• Study Start (Actual): June 27, 2017
• Primary Completion (Actual): September 30, 2019
• Study Completion (Actual): September 30, 2019

Study Registration Dates

• First Submitted: May 25, 2018
• First Submitted That Met QC Criteria: May 25, 2018
• First Posted (Actual): June 8, 2018

Study Record Updates

• Last Update Posted (Actual): February 15, 2022
• Last Update Submitted That Met QC Criteria: January 31, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: Emergency; End of life; Spotting; criSTAL
• Additional Relevant MeSH Terms: Pathologic Processes; Death
• Other Study ID Numbers: RC31/15/7732; 2016-A00116-45 (Other Identifier: ID-RCB)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No